Efficacy of Post-Operative Oral Prednisolone for the Control of Disease in Allergic Fungal Sinusitis

2021 ◽  
pp. 13-17
Keyword(s):  
Study Groups ◽  
Sinus Surgery ◽  
Oral Steroid ◽  
P Value ◽  
Complete Relief ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Oral Steroids ◽  
Group A ◽  
Group B

Background: Ambiguity persists regarding the dosage, frequency, and duration for the use of oral steroids in Allergic Fungal Sinusitis (AFS). Objective: To assess the efficacy of post-operative oral steroid (prednisolone) for the control of disease in Allergic Fungal Sinusitis. Methodology: This was a comparative study, conducted at Bahawal Victoria Hospital, Bahawalpur from January 2019 to March 2019. A total of 40 patients, aged 18 or above with weight over 50 kilograms, having proved Allergic Fungal Sinusitis (AFS) as per criteria defined by Deshazo and Swain, were recruited for this study. All the patients were enrolled within 14 days of excisive sinus surgery adopting endoscopic sinus surgery with or without open methods. Group A (n=20) received oral steroids while Group B (n=20) received a placebo. Patients of both groups also used fluticasone nasal spray and oral itraconazole. Evaluation of all the patients was done at the time of enrollment, 6 and 12 weeks. Data were analyzed by SPSS version 21. Results: Out of a total of 40 patients, 17 (42.5%) were males. After 6 weeks of continuous therapy in both the study groups, 14 (70%) patients of Group A showed complete relief of symptoms in comparison to none in Group B (p-value = 0.001). After 12 weeks of therapy having tapering off in both study groups, all patients in Group A had complete relief of symptoms in comparison to only one (5%) in Group B (p-value = 0.001). Conclusion: Oral steroids of prednisolone, along with inhaled steroids therapy for a minimum of 12 weeks after excisive sinus surgery were found efficacious for the control of disease in patients with Allergic Fungal Sinusitis.

scholarly journals Efficacy of Tamsulosin and Alfuzosin in Management of Distal Ureteral Stones

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 10-13
Author(s):  
Bimochan Piya ◽  
Abhishek Bhattarai
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Diclofenac Sodium ◽  
Study Groups ◽  
Ureteral Stones ◽  
Control Group ◽  
P Value ◽  
Expulsion Rate ◽  
Group A ◽  
Group B

Introduction: Urinary tract calculi are the most frequent condition in urology clinics worldwide. The overall prevalence is about 5 % and lower urinary tract stones account for 70% among them. Medical expulsive therapy has been used to treat distal ureteric stone as it reduces symptoms and facilitates stone expulsion. The aim of this study is to evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones. Materials and Methods: A total of 87 patients with distal ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group A patients (n-30) received 0.4 mg of tamsulosin daily, group B patients (n-29) received 10 mg of alfuzosin daily and group C patients (n-28) received 75 mg of diclofenac sodium. Patients in all groups received diclofenac sodium for one week and then as required. Follow-up was done on a weekly basis for 4 weeks. The stone expulsion rate, time for stone expulsion, and side-effects were recorded in each group. Results: The mean stone size (5.66, 5.79, 5.67) mm and age (29.1, 30.31, 29.4) were comparable in each group. The stone expulsion rate was 83.3%, 79.3%, and 50% in groups A, B, and C respectively.  It showed that both the study groups (Group A and Group B) were effective than the control group (p-value 0.006 and 0.02 respectively) but there was no difference between tamsulosin and alfuzosin (p-value 0.69). The duration of stone expulsion was 11.5 days, 11.8 days, and 17.3 days for Group A, B, and C respectively. The drugs related side effects reported by patients were mild and transient. Conclusion:  The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other.

scholarly journals COMPARISON OF ONDANSETRON AND METOCLOPRAMIDE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA.

2019 ◽  
Vol 26 (07) ◽  
pp. 1197-1202
Author(s):  
Hajra Shuja ◽  
Mehmood Ali Shah ◽  
Sadaf Bokhari
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Study Groups ◽  
P Value ◽  
Significant Difference ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Trial Setting

Background: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. It is a safe and effective treatment in many cases. General anesthesia has a high incidence for PONV. But anti-emetic drugs can help in preventing PONV. Objectives: To compare the efficacy of ondansetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anesthesia. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Sheikh Zayed Hospital, Lahore. Period: 6 months i.e. from 15-2-2017 to 15-8-2017. Material & Methods: The patients were divided into two groups. Ondansetron was given to group A patients within 15 minutes of induction, and metoclopramide to group B patients within 15 minutes of induction. Then patients were shifted to the ward after surgery and followed-up for 24 hours for assessment of PONV. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients in group A was 38.40±12.07 years and in group B was 42.63±11.77 years. The efficacy achieved in 53 were from group A and 39 were from group B Statistically significant difference was found between the study groups i.e. p-value=0.003. Conclusion: Ondansetron showed significantly better efficacy than metoclopramide in preventing PONV after laparoscopic cholecystectomy under general anesthesia.

The Role of Itraconazole in Recalcitrant Fungal Sinusitis

2009 ◽  
Vol 23 (3) ◽  
pp. 303-306 ◽  
Author(s):  
Kristin Seiberling ◽  
Peter-John Wormald
Keyword(s):  
Surgical Therapy ◽  
Retrospective Chart Review ◽  
Liver Function Tests ◽  
Oral Steroid ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Steroid Use ◽  
Elevated Liver Enzymes ◽  
Oral Steroids ◽  
Oral Itraconazole

Background Oral itraconazole is an antifungal that has been shown to be of benefit to patients with allergic bronchopulmonary aspergillus (ABPA). It is hypothesized that itraconazole may similarly benefit patients with allergic fungal sinusitis (AFS), a disease similar to ABPA. This study was designed to evaluate the therapeutic response of itraconazole in patients with refractory chronic fungal sinusitis who have failed maximal medical and surgical therapy. Methods A retrospective chart review was performed of 23 patients with AFS and nonallergic eosinophilic fungal sinusitis treated with oral itraconazole. Charts were reviewed for patient demographics, comorbidities, allergies, fungal cultures, type of surgery performed, and amount of oral steroids used before and after itraconazole. All patients were given a 6-month dose of itraconazole (100 mg b.i.d.) when recurrence developed after surgery. Time to next recurrence, change in oral steroid use, and outcomes were noted. Liver function tests were taken at monthly intervals while on itraconazole. Results Twenty-three patients, 13 men and 10 women, were started on oral itraconazole for recurrent fungal sinusitis. Nineteen patients responded to the medication with a decrease in symptoms and fungal mucin/polyps on endoscopy. Three patients had to stop because of elevated liver enzymes. In the remaining 16 patients a decrease in oral steroid use was noted. In addition, 11 of the 16 patients are disease free to date at a mean follow-up of 15.7 months. No permanent complications occurred from the use of the medication. Conclusion Oral itraconazole may be of benefit to those patients with recalcitrant fungal sinusitis who have failed maximal medical and surgical therapy. Itraconazole may prolong the time to next recurrence and may enable the patient to significantly decrease or stop oral steroids.

scholarly journals Oral versus Vaginal Micronized Progesterone for the treatment of threatened miscarriage

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Sobia Tabassum ◽  
Sajjad Masood
Keyword(s):  
Controlled Trial ◽  
Final Analysis ◽  
Study Groups ◽  
P Value ◽  
Creative Commons ◽  
Threatened Miscarriage ◽  
Vaginal Progesterone ◽  
Group A ◽  
Group B ◽  
Micronized Progesterone

Objectives: This study was planned with an aim to find out the effectiveness of oral versus vaginal micronized progesterone for the treatment of threatened miscarriage. Methods: This randomized controlled trial was conducted at The Department of Obstetrics and Gynaecology, Nishtar Hospital Multan, from August 2019 to January 2020. A total of 136 pregnant women, aged 18 to 45 years having vaginal bleeding were included and divided into two groups (68 women in each group). Participants in the Group-A were given oral micronized progesterone as 200mg twice a day while Group-B participants were given vaginal progesterone suppository 400mg once a day. All women were followed up until 20th week of their pregnancy. Outcome was labeled as prevention of miscarriage if woman had no bleeding per vagina and pregnancy went beyond 20th weeks of gestation. Results: In a total of 136 women enrolled, mean age was noted to be 30.85+3.34 years. Overall, mean gestational age was noted to be 9.3+2.7 weeks. A total of 98 women (49 in each group) completed the follow up and were included in the final analysis regarding outcome. Among Groups-A, 45 (91.8) had prevention of miscarriage while 4 (9.2%) had miscarriage in comparison to 36 (73.5%) in Group-B had prevention of miscarriage whereas 13 (26.5%) had miscarriage and this difference was statistically significant in between the both study groups as women in Group-A had significantly better outcome in terms of prevention of miscarriage. (P value = 0.0164). Conclusion: The use of oral micronized progesterone was found to be significantly more effective than vaginal progesterone in women with threatened miscarriage. doi: https://doi.org/10.12669/pjms.37.3.3700 How to cite this:Parveen R, Khakwani M, Tabassum S, Masood S. Oral versus Vaginal Micronized Progesterone for the treatment of threatened miscarriage. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3700 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals To assess the impact of various modes of postnatal breastfeeding education in promoting breastfeeding practices

2017 ◽  
Vol 4 (3) ◽  
pp. 989
Author(s):  
Venkatesh Periasami ◽  
Vinodh Muthu ◽  
Ezhil Vaanija Sakkarai ◽  
Aravind Malayappan Ayyavoo ◽  
Ganesh Jayachandan
Keyword(s):  
Statistical Difference ◽  
Study Groups ◽  
P Value ◽  
Written Information ◽  
Breastfeeding Practices ◽  
Breastfeeding Education ◽  
Visual Aid ◽  
Group A ◽  
Group B ◽  
The Impact

Background: Breast milk is the best nutrient a mother can provide her baby. WHO recommends exclusively breastfeeding up to 6 months of life.The objective of the study was to study the impact of postnatal breastfeeding education in promoting breastfeeding practices and to identify the effective mode of education.Methods: This is a RCT study conducted in Government RSRM lying-in hospital between Dec 2015 and May 2016.300 women who delivered live, term, healthy, AGA babies were divided randomly in to 3 study groups. Participants in group A were counselled about breastfeeding orally. Those in group B received written information and oral counselling. Group C members were shown an educational video apart from oral and written information. They were assessed on 15th day, 45th day, 3.5 months and 6 months using a simple questionnaire.Results: Analysis showed that during the 1st visit, there was no statistical difference between groups. However, during the last visit there was significant statistical difference between groups with a p value of 0.004.Conclusions: Audio-visual aid helps in better breastfeeding practices. Literacy status has no role in promoting breastfeeding practices. 

scholarly journals Comparative study on the effects of pre-operative intranasal steroid spray versus oral steroid on intraoperative bleed in FESS for nasal polyposis

2021 ◽  
Vol 7 (5) ◽  
pp. 782
Author(s):  
Jagannath B. ◽  
Nikitha Pillai ◽  
Bharath Kumar K. L.
Keyword(s):  
Medical Treatment ◽  
Nasal Polyposis ◽  
Oral Steroid ◽  
Time Duration ◽  
Oral Steroids ◽  
Group A ◽  
Surgical Field ◽  
Nasal Steroid ◽  
Group B

<p class="abstract"><strong>Background:</strong> Nasal polyps are associated with chronic inflammation of the nasal cavity and sinus mucosa. Steroids are the main stay of medical treatment. FESS is indicated when medical treatment fails. Bleeding during surgery can impair the surgical field during operation and increase the time duration and risks of complications. Pre-operative corticosteroids help reduce bleeding during surgery. The objectives of the study was to study and compare the effects of pre operative intra nasal steroid spray and oral steroid on intra-operative bleed in FESS for nasal polyposis.</p><p class="abstract"><strong>Methods: </strong>60 patients diagnosed with nasal polyposis were sequentially divided into 2 groups. Group A received intranasal steroid spray and Group B received oral steroid each for 7 days. Patients of both groups underwent FESS under general anaesthesia. Bleeding volume and quality of surgical field were assessed during the procedure to evaluate the effect of pre operative steroids in bleeding in FESS.</p><p class="abstract"><strong>Results: </strong>Majority of our study patients of both the groups had moderate bleed. 33.3% of Group B patients showed the best outcome of surgery with just slight bleeding while 33.3% patients of Group B had moderate to severe bleed. Majority of our study patients (53.3%) had a blood loss of about 50-100 ml, of which 66.7% patients belonged to Group B.</p><p class="abstract"><strong>Conclusions: </strong>Preoperative steroids are truly beneficial. Oral steroids has been found to be relatively better than intra nasal steroid spray in improving symptoms, reducing intra operative bleeding, and in providing better quality of surgical field.  </p><p class="abstract"> </p>

Success of Ponseti Method in Idiopathic Club Feet of <2 Years and 2-5 years of age – A Comparative Study

2021 ◽  
Vol 15 (11) ◽  
pp. 3022-3025
Author(s):  
Usman Ahmed ◽  
Ayesha Saeed ◽  
Mian Maqbool Hussain ◽  
Mumtaz Hussain ◽  
Abdul Latif Sami ◽  
...  
Keyword(s):  
Success Rate ◽  
Study Groups ◽  
Ponseti Method ◽  
P Value ◽  
Congenital Talipes Equinovarus ◽  
Female Ratio ◽  
Talipes Equinovarus ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: The Ponseti technique is the gold standard for treatment of clubfoot. However, the data in walking children is still limited and results are ill defined. Aim: We prospectively compared Ponseti method in clubfoot patients aged <2 and between 2 to 5 years in our local scenario. Methods: A total of 40 patients were included in the study through non-probability purposive sampling. The patients were examined, classified (Goldner and Fitch classification) and demographic information was recorded. They were explained about the risk and informed consent was taken. In group A, patients were below 2 years of age while in group B, patients were between 2-5 years of age. Ponseti casting was performed by a designated team. Follow-up was done for 6 months from the correction of feet. Results: We received 27(67.5%) male and 13(32.5%) female patients .The male to female ratio was 2:1. The mean age of patients in group A and B was 0.8±0.70 years and 4.3±2.1 years respectively. There was no statistical difference of severity of deformity of clubfoot in both study groups, p-value>0.05. In group A, 17 (85%) patients had success of procedure while in group B the success was achieved in 11 (55%) patients. The success rate was statistically significantly higher in group-A as compared to group B, p-value<0.001 Conclusion: Patient aged <2 years have significantly higher success rate as compared to patients aged between 2-5 years. So we recommend the Ponseti method as standard therapy in clubfoot management for patients with age<2 years and for correction of mild and moderate deformities in patients between 2 to 5 years. Keywords: Clubfoot, Congenital talipes equinovarus, Ponseti method

Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius

2021 ◽  
Vol 17 (1) ◽  
pp. 66-70
Author(s):  
Zaigham Habib ◽  
Shuja Uddin ◽  
Riaz Qadeer Niazi ◽  
Muneeb Ur Rehman ◽  
Abdul Qadir ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Controlled Trial ◽  
Kirschner Wire ◽  
Study Groups ◽  
Fixation Method ◽  
P Value ◽  
Group A ◽  
Group B

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires. Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by ‘non-probability, consecutive sampling technique’ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire). Results: The mean age in the group A and group B was 53.7 ± 11.8 years and 55.2 ± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05). Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 months’ postoperative period.

scholarly journals Comparative study of lactose and lactose free milk for acute diarrheal management in children upto 1 year of age.

2020 ◽  
Vol 27 (08) ◽  
pp. 1631-1635
Author(s):  
Muhammad Arshad ◽  
Ahmad Hassan Khan ◽  
Masood Mazhar ◽  
Nadir Ali Rana ◽  
Shoaib Ahmed ◽  
...  
Keyword(s):  
Acute Diarrhea ◽  
Controlled Trial ◽  
Study Groups ◽  
Outcome Variable ◽  
P Value ◽  
Formula Milk ◽  
Black And White ◽  
Group A ◽  
Group B ◽  
Trial Setting

Objectives: The objective of this particular research was to contrast mean duration of acute diarrhea in infants taking lactose free formula versus lactose-containing formula milk along with standard treatment. Study Design: Randomized Controlled Trial. Setting: Department of Paediatric Medicine DHQ Teaching Hospital Sargodha. Period: 6 months from 29 October 2016 to 28 April 2017. Material & Methods: This study included 60 infants of both genders who were between 1month to 1 year of age and presented with acute diarrhea. These infants were separated into two groups. Infants in Group-A were given lactose-free formula milk while those in Group-B received lactose-containing formula milk. Outcome variable was mean duration of diarrhea which was compared between the two groups. Consent was taken in black and white from parents of each infant. Results: The average age of the infants was 7.2±3.1 months. Majority (n=41, 68.3%) of the infants were aged 6 months and above followed by 19 (31.7%) infants aged between 1-5 months. There were 29 (48.3%) male and 31 (51.7%) female infants with a female to male ratio of 1.1:1 the weight of infants ranged from 2.6 Kg to 11.9 Kg with a mean of 8.1±2.2 Kg. Both study groups were compared in terms of mean age (p-value=0.741), mean weight (p-value=0.932) and age (p-value=0.781), gender (p-value=0.438) and weight (p-value=0.573) groups distribution. The mean period of diarrhea was notably shorter in infants taking lactose-free milk (1.7±0.8 vs. 2.7±0.8 days; p<0.001) as compared to those receiving lactose-containing milk. Similar significant differences were observed across various subgroups based on patient’s age, gender and weight. Conclusion: Lactose-free formula milk reduces mean duration of diarrhoea significantly when compared to lactose-containing formula milk regardless of patient’s age, gender and weight which advocate its preferred use in future practice in infants presenting with acute diarrhea.

scholarly journals Comparison of phenobarbital and sodium valproate for the treatment of status epilepticus in children.

2020 ◽  
Vol 27 (07) ◽  
pp. 1353-1357
Author(s):  
Ameer Jamali ◽  
Waqas Ali ◽  
Fazal Ur Rehman
Keyword(s):  
Status Epilepticus ◽  
Sodium Valproate ◽  
Positive Response ◽  
Pediatric Population ◽  
Statistical Significance ◽  
Febrile Convulsion ◽  
Study Groups ◽  
P Value ◽  
Group A ◽  
Group B

Objectives: Seizure is considered to be one of the commonest emergency involving more than half of the admissions in Pediatric Neurology wards. It has been well documented that proper management not only improves the prognosis but also decrease complications in these children. This study was planned to compare phenobarbital against sodium valproate for the treatment of status epilepticus (SE) in children. Study Design: Randomized clinical trial. Setting: Emergency Department of Pediatrics Medicine, the Baqai University and Medical College, Karachi. Period: 15th July 2018 to 31st December 2018. Material & Methods: A total of 100 children (50 in each group) with seizure lasting longer than 5 minutes, aged 6 months to 12 years, did not respond to diazepam (0.2mg/kg)  within five minutes, were enroll. Randomization was done using lottery system where Group A was nominated who used sodium valproate and Group B, phenobarbital. Good response was labeled if a child’s seizure was controlled within 20 minutes of treatment. Results: Out of total of 100 children included in the present study, there were 60 (60.0%) male and 40 (40.0%) female. Mean age of the children was 5.4 years with standard deviation of 2.2 years. As far as type of seizures are concerned, there were 43 (43.0%) children presented with febrile convulsions (FC) while 57 (57.0%) with SE.  Overall, positive response was noted in 69 (69.0%) children. Response in between both the groups turned out to be of statistical significance as more children, 40 (80.0%) showed positive response in Group B in comparison to 29 (58.0%) in Group A (p value = 0.017). Amongst children with positive response, the difference between both the study groups was significant in relation to seizure types as 75.9% of children with SE showed positive response with sodium valproate while 52.5% children with FC showed positive response in Group B (p value=0.018). Conclusion: Overall, both study drugs showed good positive response but phenobarbital when compared to sodium valproate is a better choice for controlling seizure in pediatric population. Sodium valproate showed greater effectiveness when used in children with SE while phenobarbital was comparatively more effective in febrile convulsion.

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