scholarly journals Effectiveness of Ponseti Versus Kite Method for the Management of Club Foot- A Quasi Experimental Trial

2021 ◽  
Vol 15 (6) ◽  
pp. 1871-1873
Author(s):  
Shabana Sharif ◽  
Rehan Ramzan Khan ◽  
Saima Riaz ◽  
Sajid Rashid ◽  
Zaigham Rasool Athar ◽  
...  

Objective: To determine the effectiveness of ponseti versus kite method for the management of club foot among children. Methods: A quasi experimental trial was conducted to determine the most effective conservative method for managing idiopathic club foot. This study was carried out in District Head Quarter Hospital, Layyah. A total of 46 children (60 Feet) aged less than six months of both genders were included in this study using convenience sampling technique. The study sample was divided into Group A (Ponseti) and Group B (Kite). Each treatment group comprises of 30 feet. Patients were called for weekly follow up till ten weeks consecutively. At every follow-up visit, patients were assessed to check the improvement of deformity with the help of the Pirani scoring system for the foot. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. A greater negative value signified better correction. SPSS 23 was used for data entry and analysis. Results: Children's mean age in both treatment groups (A and B) was 10.83±4.59 and 10.20±4.75 weeks. At presentation mean Pirani score in both treatment groups (A and B) was 5.85±0.67 and 5.86±0.45, respectively, while at 10th follow up it was 1.42±0.39 and 2.35±0.54 for group A and group B, respectively. Conclusion: This study demonstrates that the Ponseti technique significantly improved the management of club foot as that of the Kites method. Ponseti's method is more effective in terms of rapid improvement in the involved group. Key words: Non operative Management, Idiopathic Club foot, Kites method, Ponseti method.

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S521-25
Author(s):  
Sunarays Akhtar ◽  
Uzma Gul ◽  
Arfat Jawaid ◽  
Khalid Azam ◽  
Muhammad Sohail Babur Niazi ◽  
...  

Objective: To compare the outcome of myringotomy with and without grommet insertion in the patients of otitis media with effusion in terms of improvement of hearing in a one-month follow-up. Study Design: Quasi experimental study. Place and Duration of Study: Pakistan Airforce Hospital Jacobabad and Combined Military Hospital Lahore Pakistan, from Jan to Dec 2020. Methodology: A total of 28 patients aged 4-12 years diagnosed to have conductive hearing loss due to otitis media with effusion not responding to medical treatment were included. Non probability convenience sampling was done. Children aged less than 4 years and above 12 years were not included in the study. They were randomly divided into two groups of 14 patients each using lottery method. Group A underwent myringotomy alone whereas group B underwent myringotomy with grommet insertion. Patients in both groups also underwent adenoidectomy on case-to-case basis. Both groups were compared in terms of improvement in hearing post operatively in a one-month follow-up. Results: There was statistically significant reduction in air bone gap at the end of follow up period as compared to preoperative air bone gap in group B (p=0.007). In group A there was statistically significant reduction in air bone gap at one week (p=0.002) however this improvement was not maintained at 4 weeks (p=0.386). Conclusion: Myringotomy with grommet insertion had significantly more patients with improved hearing as compared to myringotomy alone after one month.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S612-16
Author(s):  
Maryam Khan ◽  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz ◽  
Zaheer Ul Hassan ◽  
Attique Ahmed ◽  
...  

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.


2019 ◽  
Vol 10 (2) ◽  
pp. 1551-1555
Author(s):  
Ahmed Abdulameer Alwan ◽  
Hussain T. Ajeel ◽  
Ahmed Hamza Abd

To evaluate the efficacy & safety of tamsulosin alone versus tamsulosin plus tadalafil combination as expulsive medical treatment of distal ureteric calculus. From March 2015 utile March 2017, two hundred patients (one hundred thirty males and seventy females), who attended the outpatient urology clinic and presented with stones size 5 to 10 mm in distal ureteric part, have been randomly allocated into two equal treatment groups. Group A treated with tamsulosin alone, and group B treated with tamsulosin plus tadalafil. Both treatments were given for a maximum of six weeks’ duration. The rate and time to the calculous passage, type of analgesic use, adverse effects of the drugs, number of outpatient urology clinic visits for pain, and follow-up were noted. Both treatment groups have higher expulsion rate with a lower time to expulsion with no statistically significant differences between them (p=0.350, p=0.074, respectively). Group B showed a significantly lower rate in admission to the hospital for pain and need for analgesia than in group A. no dangerous adverse events had been observing in both groups. Additional benefit seen in group B was the improvement in erectile function regarding male patients. Using tamsulosin and tadalafil as an expulsive medical treatment for distal ureteric calculous is safe and efficacious. Such combination therapy may provide additional advantages in cases of erectile dysfunction co-exist with distal ureteric calculi.


2021 ◽  
Vol 15 (10) ◽  
pp. 3406-3409
Author(s):  
Sarah Riaz ◽  
Najia Ahmed ◽  
Ayesha Anwar ◽  
Moizza Tahir ◽  
Farrah Yousaf ◽  
...  

Objective: comparison of efficacy of topical 4% hydroquinone monotherapy with combination of oral tranexamic acid and topical 4% hydroquinone in the treatment of epidermal melasma Study design: Quasi experimental study Study period and place: Dermatology OPD, Pak Emirates Military Hospital Rawalpindi from July 2018 to January 2019. Methodology: Total 80 patients presenting with epidermal melasma were selected from outdoor patient department after applying the inclusion criteria and consent was taken from selected patients. Study was started after getting permission from hospital ethical review board. Two treatment groups were made after dividing patients by using alternate method. Treatment with topical 4% hydroquinone alone was started for group A patients and combination of capsule tranexamic acid (250 mg two times a day) along with topical 4% hydroquinone were started for group B patients for the next 6 months. Evaluation of patients through detailed history, clinical and wood’s light examination before starting therapy and after of 24 weeks of treatment was done for both groups. Efficacy of treatment was assessed via Modified MASI score. Results: Hydroquinone monotherapy was effective in 21 (52.5%) patients among group A while in group B patients, combination treatment i.e. oral tranexamic acid and topical hydroquinone, was effective in 31 (77.5%) patients (p value= 0.01). Conclusion: Effectiveness of Hydroquinone 4% topical therapy combined with oral tranexamic acid for epidermal melasma is better than topical 4% hydroquinone alone. Key words: Epidermal melasma, oral tranexamic acid, topical 4% hydroquinone.


2019 ◽  
pp. bjophthalmol-2018-313313
Author(s):  
Isaac Aleman ◽  
Javier Castillo Velazquez ◽  
Sloan W Rush ◽  
Ryan B Rush

PurposeTo compare the effectiveness of intravitreal ziv-aflibercept (IVZ) to intravitreal bevacizumab (IVB) administered preoperatively to patients undergoing pars plana vitrectomy (PPV) for severe manifestations of proliferative diabetic retinopathy (PDR).DesignRandomised clinical trial (RCT).MethodsTwo hundred and six patients with PDR-related complications requiring PPV were randomised into one of two treatment groups: Group A received IVZ (1.25 mg/0.05 mL) 1–10 days before PPV, while Group B received IVB (1.25 mg/0.05 mL) 1–10 days before PPV. The primary outcome was best-corrected visual acuity (BCVA) at 6 months follow-up. Secondary outcome measures were perioperative tractional retinal detachment (TRD) rates, surgical times, intraoperative and postoperative complications and incidence of unplanned PPV during the 6 month study interval.ResultsOne hundred and seventy three subjects underwent PPV and completed the 6-month follow-up interval. Group A subjects had better BCVA at 6 months (p=0.0035), shorter surgical times (p=0.0013) and were less likely to have a recurrence of vitreous haemorrhaging in the postoperative period (p=0.0101) when compared with subjects in Group B. There were no significant differences among the treatment groups with regards to baseline characteristics, perioperative TRD development, intraoperative complications and incidence of unplanned PPV during the 6 month study interval.ConclusionsThis RCT demonstrated better final visual outcomes, shorter operating times and less vitreous haemorrhage recurrences in the postoperative period when subjects received IVZ compared to IVB prior to PPV for the treatment of PDR-related complications.


Author(s):  
G. Chitti Babu ◽  
Kavita Dhar Bagati ◽  
Praveen Agarwal ◽  
Jyostna Sharma

Background: Efficacy of these modalities as shown by various investigations are inconsistent and ambiguous. Thus, evidence based effective treatment option is warranted. Aim of the study was to compare the efficacy of oral ivermectin, topical permethrin and benzyl benzoate in the treatment of uncomplicated scabies.Methods: Patients with confirmed diagnosis of scabies were included in this study. One hundred and ninety-five subjects were included in this investigation as per inclusion and exclusion criteria laid down. Equal numbers of patients were randomly allocated to one of the three treatment groups. Efficacy of three groups [oral ivermectin (Group A), topical permethrin (Group B) and benzyl benzoate (Group C)] of drugs was compared in terms of improvement in clinical grading of disease (%) and improvement in clinical grading of pruritus (%) during follow up visits.Results: Those subjects receiving topical permethrin, at 1st follow up 56.9% showed cure rate which increased to 89.2% at 2nd follow up with respect to clinical improvement in pruritus. Maximum relief in severity of pruritus at the end of 6th week was reported by 58(89.2%) patients receiving group B treatment modality followed by 52 patients (80%) in arm A. Regarding efficacy of three treatment groups in terms of improvement in severity of lesion at the end of 6 weeks, maximum number of patients 57(87.7%), receiving group B treatment reported improvement which is better than other two treatment groups.Conclusions: maximum number of patients receiving topical Permethrin treatment reported improvement better than other Oral Ivermectin therapy and topical benzyl benzoate. Oral ivermectin may serve a good alternative for managing scabies under certain conditions like poor compliance to topical scabicides.


2014 ◽  
Vol 21 (03) ◽  
pp. 471-476
Author(s):  
Malik Muhammad Yasin Awan ◽  
Ijaz Ahmad ◽  
Amer Aziz

Objective: To assess the efficacy and safety of aceclofenac in the treatment ofosteoarthritis. Study design: Randomized double blind Phase IV trial. Place and Duration ofstudy: This study was conducted in the department of Orthopaedics & Spine Surgery, GhurkiTrust Teaching Hospital, Lahore. The duration was eight weeks. Methodology: A total of 90subjects, fulfilling the inclusion criteria and willing to give free informed consent were enrolled inthis trial. All these subjects were randomized into two treatment groups (A & B). Subjects eitherreceived Aceclofenac 100 mg twice daily or Diclofenac 75 mg twice daily for 08 weeks. During thescreening visit, information on their demographic characteristics, medical history and previousand current medications were collected. A thorough physical examination and necessarylaboratory investigations were carried out before drug administration and after the completion oftreatment (end of week 8). Clinical examination was done at baseline visit, randomization and 2, 4and 8 weeks. Gastrointestinal (GI) safety was assessed using adverse drug reaction (ADR)reports. WOMAC questionnaire was used to see improvement in activities of daily living and painwas assessed using visual analogue scale (VAS). All data was collected in the case report form(CRF). Statistical evaluation was performed at the end of the trial and results were analyzed usingSPSS. Results: 70 subjects completed the study while 20 were lost in follow-up. There were 28males and 34 females in the study with mean age of 56 years. There was a significant decrease inWOMAC and VAS scores in both groups. In group A (Diclofenac group) VAS decreased from7.107 to 2.538 (p= 0.000) and WOMAC decreased from 32.75 to 7.38 (p=0.000). In group B(Aceclofenac group), VAS decreased from 7.912 to 6.0 (p=0.001) while WOMAC decreased from37.29 to 21.50 (p=0.000) showing the efficacy of both drugs. There was also significant decreasein the disease severity in both groups at the end of treatment. But the safety profile of (Diclofenac)group A was not significant (p=0.767) as compared to (Aceclofenac) group B (p=0.022).Conclusions: Aceclofenac is efficacious and safe drug for the treatment of osteoarthritis in adultsas compared to Diclofenac.


2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh

Purpose:  To compare between 10/0 nylon monofilament and 8/0 virgin silk for conventional trabeculectomy in terms of rate of complications and bleb morphology. Study Design:  Quasi experimental study. Place and Duration of Study:  Abbasi Shaheed Hospital, Karachi, from January 2017 to December 2018. Methods:  Thirty six patients who underwent conventional trabeculectomy with 6 months follow-up were included. Trabeculectomy for congenital, neovascular, traumatic glaucoma, revised surgery and laser trabeculoplasty were excluded. In group A, scleral flap and conjunctiva were closed with 8/0 virgin silk and in group B, 10/0 nylon monofilament was used. Main outcome measure was complications. Results:  Group A had 13 (36%) and group B had 23 (63.9%) patients. Mean age was 55.5 ± 10.69. Pre-operative Intraocular pressure (IOP) was 33.4 ± 6.3 and 33.5 ± 12 mm Hg in group A & B respectively. Postoperatively at 3rd month IOP was 16.8 in group A and 15.0 in group B (p = 0.24).Shallow Anterior chamber was in 53% (n = 7) patients with 8/0 silk and 13% (n = 3) patients with 10/0 nylon with p value of < 0.05. Seidel test was positive in 38% (n = 5) patients in group A (p < 0.01). Re-suturing was done in 38% (n = 5) patients in group A with a p-value (p < 0.01). Conclusion:  Shallow anterior chamber, wound leak with positive seidel test and additional intervention for re-suturing were more common in group A than group B. Diffuse blebs were frequently seen with both suture materials. Suture material does not affect final intra ocular pressure and success of trabeculectomy. Key Words:  Bleb, Trabeculectomy, 10/0 Nylon, 8/0 silk.


2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S273-76
Author(s):  
Muhammad Rizwan ◽  
Naeem Raza ◽  
Ayesha Anwar ◽  
Ayesha Khokhar

Objective: To compare the efficacy of oral fluconazole and oral itraconazole in the treatment of Pityriasisversicolor. Study Design: Comparative prospective study. Methodology: Total 72 patients of both genders with Pityriasis versicolor were included. Patients were randomly allocated into two treatment groups with 36 patients in each group: group A and group B by lottery method. Patients in group A received Cap Fluconazole 150 mg bi- weekly for two consecutive weeks while those in group B received two doses of 400 mg of itraconazole once weekly for two weeks. Patients were asked to follow-up after 4 weeks skin scrapings for microscopy using 10% KOH mount was done at follow-up. Efficacy was assessed in terms of negative fungal hyphae on microscopy. Results: In this study, age ranged from 18 to 40 years with mean age of 33.52 ± 4.12 years in group A, whereas35.055 ± 4.18 years in group B. Mean duration of disease was 4.66 ± 1.51 months in group A and 5.27 ± 1.70months in group B. Efficacy was seen in 77.8% of group A patients as compared to 50% in group B patients(p=0.014). Conclusion: Oral Fluconazole two doses of 150 mg/week (total 300mg/week) for two consecutive weeks wasfound more effective than oral itraconazole.


2021 ◽  
Vol 14 (6) ◽  
pp. 844-848
Author(s):  
Bo Yu ◽  
◽  
Jia-Ying Sun ◽  
Qian Ye ◽  
Yun-Hai Tu ◽  
...  

AIM: To establish the necessity of silicone tube intubation in acute dacryocystitis (AD) patients undergoing endonasal endoscopic dacryocystorhinostomy (En-DCR). METHODS: Patients presenting with unilateral AD were randomly assigned to two treatment groups. En-DCR procedures were performed following lacrimal abscess formation, with the operation being performed with silicone intubation for patients in group B but not group A. Functional success was defined by an absence of additional AD episodes, no epiphora, and ostium patency as established via endoscopic evaluation or fluorescein irrigation. Operative success rates and demographic variables were compared between treatment groups. RESULTS: In total, 66 patients were analyzed in the present study (33 per group), with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B, respectively. All patients exhibited complete resolution of acute inflammation. Upon follow-up, granulation tissue was detected around the ostium at higher rates in group B (9/22, 40.9%) relative to group A (4/27, 14.8%). At the 12-month follow-up time point, patients in group A exhibited higher success rates (25/27, 92.6%) relative to patients in group B (20/22, 90.9%), but this difference was not significant. Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium. CONCLUSION: Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation, cost, and operative duration, these data do not support the routine silicone intubation of AD patients following En-DCR surgery.


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