scholarly journals The Incidence and Frequency of Various Causes of Angioedema in Emergency Medicine

2018 ◽  
Vol 47 (1) ◽  
pp. 11
Author(s):  
Ljerka Karadža-Lapić ◽  
Tamara Pikivaca ◽  
Petra Pervan ◽  
Josipa Jović Zlatović ◽  
Sanja Delin ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Case Reports ◽  
Subsequent Treatment ◽  
Chi Square ◽  
Significant Difference ◽  
Causative Agents ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Insect Bites

<p><strong>Objective. </strong>Angioedema (AE) is a potentially life-threatening event. We investigated the etiology of AE, with the emphasis on bradykinininduced angioedema treatment in emergency medicine.</p><p><strong>Methods. </strong>The retrospective study included 237 patients with AE, who were examined and treated in two hospitals (group A and B) in Croatia from 2009 to 2016. The location and duration of AE, data about chronic diseases and treatment, potential causative agents (food, drugs, insect bites and chemicals), physical examination data and the subsequent treatment were analyzed.</p><p><strong>Results. </strong>There was no statistical difference regarding age or comorbidities but there was a statistically significant difference in etiology between the groups (Chi-square, P=0.03). Renin-angiotensin-aldosterone system (RAAS) blocker induced AE was the main cause of emergency attendance in group A (37.5%) and among the leading causes in group B (18.8%). Bradykinin-induced AE (hereditary angioedema (HAE) and RAAS-AE) were the leading causes in a total of 75 (31.5%) patients. RAAS-AE was treated with glucocorticoids and antihistamines. HAE attacks in both groups (2/7 patients, 1.5/6%) were treated with specific therapy. Other causes of AE in groups A/B were insect bites (15/23 patients, 13.5/20%), use of antibiotics/analgetics (11/17 patients, 9/15%), gastroesophageal reflux disease (10/11 patients, 8/9%), neoplasms (5/6 patients, 4/5%) and idiopatic (32/31 patients, 26.5/26%). 21% of patients were hospitalized.</p><p><strong>Conclusion. </strong>Bradykinin-mediated AE was the main cause of emergency attendance associated with AE. Advances in the treatment of HAE, with case reports of patients with RAAS-AE treated with C1 esterase inhibitor concentrate or bradykinin receptor antagonist, may prove to be a new, reliable and efficacious therapy option.</p>

Resorbable Collagen Barrier Impeding the Extrusion of Obturating Material in Primary Molars Undergoing Resorption – A Randomized Clinical Trial

2021 ◽  
Vol 45 (5) ◽  
pp. 312-316
Author(s):  
Mishra Neha Sanjeev ◽  
Harsimran Kaur ◽  
Sandeep Singh Mayall ◽  
Rishika ◽  
Ramakrishna Yeluri
Keyword(s):  
Test Group ◽  
Primary Molars ◽  
Control Group ◽  
Chi Square ◽  
Significance Level ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B ◽  
And Control

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p &lt; 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p&gt;0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.

Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Santosh Kumar ◽  
Rajesh Roat ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Ravimohan S. Mavuduru ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Erectile Function ◽  
T Test ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

Accuracy of Paper Point Technique for Final Working Length Measurement after Canal Preparation

2021 ◽  
Vol 15 (10) ◽  
pp. 3359-3362
Author(s):  
Ambrin . ◽  
Farah Tasleem ◽  
Anum Saleem ◽  
Doua Tasleem ◽  
Talha Ahmed
Keyword(s):  
Controlled Trial ◽  
Length Measurement ◽  
Chi Square ◽  
Paper Point ◽  
Working Length ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B ◽  
Electronic Apex Locator

Objective: The aim this study was to check the accuracy of paper point technique for final working length measurement after canal preparation. Study Design: Randomized controlled trial Place and Duration: Study was performed in department of operative dentistry, Liaquat University of Medical & Health Sciences, Jamshoro for one year duration from January 2017 to December 2017. Methodology: This study was performed on 78 patients divided equally into two groups. In one group working length was established by using electronic apex locator while in second group working length was established by using electronic apex locator with paper point technique. To check the working length master apical gutta percha point (GP point) was inserted into canal and radiograph were taken by paralleling angle technique. Results: There were 34 (43.6%) males while 44 (56.4%) patients were females. Mean age of patients was 30.5±8.9 years. Mean tooth number was 28.8±11.0. Group A is concerned that was treated only with Electronic Apex Locator showed lesser number of acceptable length than group B. on the other hand, group B was treated with electronic apex locator and paper point technique showed higher acceptable length of respondents with a difference of 4 frequencies or 7% in excess. A less value of chi-square test showed relationship between observed and expected data; whereas, significance value indicated no significant difference between group A and B. Conclusion: Paper point technique is as reliable as other techniques for final working length measurement. Key Words: Electronic Apex Locator, Paper Point Technique, Endodontic Working Length

scholarly journals The role of glucomannan fiber in childhood functional constipation

2016 ◽  
Vol 56 (2) ◽  
pp. 95
Author(s):  
Indiana Aulia ◽  
Supriatmo Supriatmo ◽  
Emil Azlin ◽  
Atan Baas Sinuhaji
Keyword(s):  
Controlled Trial ◽  
Functional Constipation ◽  
Boarding School ◽  
Chi Square ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Rome Iii ◽  
Group A ◽  
Group B

its most common type is functional constipation. The dietary fiber may be useful in childhood functional constipation management, but unfortunately the role of fiber in functional constipation is still less developed.Objective To determine the role of glucomannan in treatment of childhood functional constipation.Methods A crossover randomized controlled trial (RCT) was done from May until July 2012 in a boarding school in Medan, North Sumatera. The subjects were children with functional constipation aged 7 to 12 years. Subjects were randomised into two group receiving glucomannan fiber as polysaccharide gel (group A) and maltodextrin as placebo (group B) with each dose of 100 mg/kg/day (maximum of 5 g/day) diluted in 50 ml water/500 mg for 4 weeks, then after a wash out period we did the crossover of the two groups. Frequency and consistency of stools were recorded into diary sheet for 4 and 8 weeks of treatment. Functional constipation has been diagnosed based on Rome III criteria. Data was analyzed using independent T-test and Chi-square test.Results A total of 36 subjects were eligible with each group consisting of 18 subjects and mean of weight of 25 kg. We found significant difference in stool frequency, treated on glucomannan with P= 0.002 before and P = 0.0001 after the wash out period. For stool consistency, we found difference while treated on glucomannan 9/18 (P= 0.034) in 4 weeks before and 11/18 (P = 0.008) in 4 weeks after the wash out period.Conclusion Glucomannan has significant effect to improve functional constipation especially in 4 weeks treatment.

scholarly journals Impact of smartphone digital photography, email, and media communication on emergency room visits post-hypospadias repair

2017 ◽  
Vol 11 (3-4) ◽  
pp. 134 ◽  
Author(s):  
Michael E. Chua ◽  
Megan A. Saunders ◽  
Paul R. Bowlin ◽  
Jessica M. Ming ◽  
Roberto Iglesias Lopes ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Digital Photography ◽  
Hypospadias Repair ◽  
Chi Square ◽  
Email Communication ◽  
Media Communication ◽  
Group Assignment ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction: Advances in communication technology are shaping our medical practice. To date, there is no clear evidence that this mode of communication will have any effect on unnecessary postoperativeemergency room (ER) visits. We aim to evaluate the effect of email and media communication with application of smartphone digital photography on post-hypospadias repair ER visit rates.Methods: This prospective cohort study included all patients who underwent hypospadias repair performed by a single surgeon from October 2014 to November 2015. Patients were categorized intotwo groups: Group A consented for smartphone photography and email communication and Group B declined. Reason for ER visits within 30 days postoperatively was assessed by another physician, who was blinded of patient group assignment. The reasons were categorized as: unnecessary ER visit, indicated ER visit, or visit unrelated to hypospadias surgery. Chi-square test and T-test were used for statistical analysis. Relative risk (RR) and corresponding 95% confidence interval (CI) were also calculated. Statistical significance was set at p<0.05.Results: Over a 14-month period, 96 patients underwent hypospadias repair (81 in Group A, 15 in Group B 5). No significant difference was noted between groups for overall ER return rate (RR 0.46, 95% CI 0.21, 1.0). However, the number of ER visits for wound check not requiring intervention was significantly lower in Group A than in Group B (RR 0.14, 95% CI 0.035, 0.56); likewise, a higher number of ER visits requiring intervention was noted in Group A compared with Group B, although statistically this was not significant (RR 1.67, 95% CI 0.23, 12.21).Conclusions: Email communication with the use of smartphone digital photography significantly reduced the number of unnecessary ER visits for post-hypospadias wound checks.

Therapeutic Efficacy of Calcium Hydroxide as an Intra Canal Dressing on Postoperative Reaction of Patients with Residual Pulpitis

2013 ◽  
Vol 749 ◽  
pp. 211-214
Author(s):  
Hui Xiao Yang
Keyword(s):  
Postoperative Pain ◽  
Calcium Hydroxide ◽  
Therapeutic Efficacy ◽  
Treatment Session ◽  
Chi Square ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

To evaluate the therapeutic efficacy of calcium hydroxide as an intra canal dressing on controlling postoperative pain and swelling in patients suffering from residual pulpitis. 118 patients with residual pulpitis in their anterior teeth participated in this study. These patients were randomly divided into two groups (group A and group B) of fifty-nine. All teeth were treated with root canal therapy with a two-visit approach. The patients in group A were treated with calcium hydroxide as an intra canal dressing , and in group B using formocresol as an intra canal dressing. All of the patients were followed up for 72 h after each treatment session. The postoperative incidence and severity of pain and swelling were recorded. The data were analyzed by chi-square test and variance analysis. After the first visit, the incidence and severity of pain and swelling showed to be higher in group B and lower in group A. These differences were statistically significant. After the second visit, the incidence and severity of pain and swelling showed to be still higher in group B and lower in group A. But there were no significant difference. Conclusion It is concluded that calcium hydroxide as an intra canal dressing could be effective to decrease the postoperative pain and swelling. It is recommended to use calcium hydroxide as an inter-appointment dressing in teeth with residual pulpitis.

Treatment Strategy for Patients with HR-Positive HER2-Negative Metastatic Breast Cancer That Progressed on CDK4/6 Inhibitors

Breast Care ◽  
2021 ◽  
pp. 1-8
Author(s):  
Shouko Hayama ◽  
Rikiya Nakamura ◽  
Toshiko Miyaki ◽  
Makiko Itami ◽  
Naohito Yamamoto
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Option ◽  
Metastatic Breast ◽  
Mtor Inhibitors ◽  
Subsequent Treatment ◽  
Rank Test ◽  
Significant Difference ◽  
Group A ◽  
Group B

<b><i>Background/Aims:</i></b> The study aim was to evaluate if mTOR inhibitors can be considered as a treatment option for HR+ HER2− metastatic breast cancer (MBC) after progression on CDK4/6 inhibitors in clinical practice. <b><i>Methods:</i></b> We retrospectively collected the clinicopathological data of patients with HR+ HER2− MBC treated with CDK4/6 inhibitors and subsequent therapies at our institution between 2014 and 2020. The patients were divided into 3 groups according to the type of subsequent treatment: (A) exemestane plus everolimus, (B) endocrine monotherapy, and (C) chemotherapy. Overall survival (OS) was estimated by using the Kaplan-Meier method and compared by using the log-rank test. The efficacy and adverse events (AEs) of each subsequent treatment were assessed by using Fisher’s exact tests. <b><i>Results:</i></b> Eighty-six patients (34 in group A, 20 in group B, 32 in group C) were included. The most common endocrine therapy in group B was fulvestrant (40%). The major chemotherapy regimen in group C was eribulin (25%). The median OS times after stopping CDK4/6 inhibitors were 34.5 months (95% confidence interval, 17.2 to NA), 13.6 months (3.9 to NA), and 19.5 months (18.8 to NA) in group A, group B, and group C, respectively. The only significant difference in OS was observed between group A and group B (20.9 months; <i>p</i> = 0.003). There was no difference in the incidence of grade 3 AEs between groups A and C or in the frequency of treatment discontinuation because of AEs among the 3 groups. <b><i>Conclusion:</i></b> Our study shows that mTOR inhibitors might be an effective treatment option for patients with HR+ HER2− MBC previously treated with CDK4/6 inhibitors.

scholarly journals A comparative study of collagenase ointment versus povidone-iodine dressing in non-healing ulcers

2017 ◽  
Vol 4 (6) ◽  
pp. 1992
Author(s):  
Amul Bhedi ◽  
Mithun Panchal ◽  
Hitesh Patel ◽  
Arnab Sarkar
Keyword(s):  
Hospital Stay ◽  
Povidone Iodine ◽  
Age Distribution ◽  
Complete Healing ◽  
Chi Square ◽  
Average Hospital ◽  
Female Ratio ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The aim of the study was to evaluate effect of collagenase ointment and povidone-iodine on non-healing ulcer in the form of duration of ulcer covered with red granulation tissue and total hospital stay.Methods: The Study was conducted on 80 patients admitted in Surgery Department, SSG Hospital and Medical College Baroda, Gujarat, India during November 2006 to October 2008. All ulcers due to trauma, chronic ulcer or infected ulcer following debridement and incision and drainage were included in this study. In group A were wounds dressed in collagenase ointment and in group B were wounds dressed in povidone-iodine ointment till second surgery or complete healing. All data from both groups were collected and analyzed by chi-square test.Results: In this study, there was no difference in age distribution (p=0.62, p>0.05) with similar male to female ratio in both groups and also no significant difference in distribution of wounds size in both groups (p=0.92, p>0.05). Average size of wound in group A was 43 sq. cm and group B was 44 sq. cm. The significant difference was seen on floor of ulcer by healthy granulation which came on an average of within 11days in group A and within 18 days in group B (p=0.005, p<0.05). There was also a significant difference in average hospital stay, which was 25 days in group A and 35 days in group B (p=0.01, p<0.05).Conclusions:Collagenase ointment is clinically more efficient as a topical dressing and lowers the morbidity by reducing the hospital stay and the duration of dressing by promoting healing in non-healing wounds than povidine-iodine ointment. 

scholarly journals Anterior Shoulder Dislocation Reduction Managed Either with Midazolam or Propofol in Combination with Fentanyl

2014 ◽  
Vol 21 (6) ◽  
pp. 346-353 ◽  
Author(s):  
T Cimilli Ozturk ◽  
O Guneysel ◽  
H Akoglu
Keyword(s):  
Emergency Medicine ◽  
Prospective Trial ◽  
Vital Signs ◽  
Respiratory Compromise ◽  
Intravenous Fentanyl ◽  
Orthopaedic Surgeons ◽  
Dislocation Reduction ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective Procedural Sedation and Analgesia is used in managing emergency painful procedures. The aim of this study is to compare the effects of propofol and midazolam on haemodynamic parameters when used in combination with fentanyl in isolated anterior shoulder dislocations and to measure the patient and physician satisfactions. Methods The study is a randomised single blind prospective trial. All procedural sedations were performed by emergency medicine specialists and the shoulder reductions were performed by orthopaedic surgeons. Two groups were defined. Group A received intravenous fentanyl and midazolam and Group B received intravenous fentanyl and propofol. The orthopaedic surgeons were not informed about the drugs. The emergency medicine specialist observed the patients. The patients and the orthopaedic surgeons were asked for a satisfaction scoring. Results Midazolam group consisted of 37 patients and propofol group consisted of 38 patients. Both groups were similar in demographic characteristics and pre-procedural vital signs. There was only one statistically significant difference at one time and it was the 5th minutes SpO2 levels between groups. There were statistically significant changes in the measurements of vital parameters in both groups when compared with the baseline levels. However none of them was clinically important. In midazolam and propofol group, 10.8% and 10.5% respectively had respiratory compromise. Patient and physician satisfactions were similar in both groups. Conclusions Midazolam and propofol are both relatively safe drugs using in combination with fentanyl in anterior shoulder dislocations. Patients and physicians can be highly satisfied with the two groups of drugs. (Hong Kong j.emerg.med. 2014;21:346-353)

Cerebrospinal fluid rhinorrhoea: does fibrin glue change the surgical outcome?

2020 ◽  
Vol 134 (7) ◽  
pp. 582-585
Author(s):  
P B Ganesh ◽  
B M Basavarajaiah ◽  
B A Rudrappa ◽  
S K Kasaragod
Keyword(s):  
Cerebrospinal Fluid ◽  
Fibrin Glue ◽  
Cerebrospinal Fluid Leak ◽  
Chi Square ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B ◽  
Fluid Leak

AbstractObjectiveCerebrospinal fluid rhinorrhoea takes place when there is a breakdown of the barriers separating the nasal cavity from the subarachnoid space. The aim of this study was to assess the surgical outcomes of endoscopic transnasal cerebrospinal fluid leak repair with and without fibrin glue.MethodThere were 43 patients with cerebrospinal fluid rhinorrhoea who underwent surgery for cerebrospinal fluid leak repair between 2014 and 2018. Patients were divided into group A, where fibrin glue was used, and group B, where fibrin glue was not used.ResultsIt was found that 74.4 per cent of cases were due to spontaneous cerebrospinal fluid leak. The most common site of a leak was the cribriform plate (65 per cent). There was a success rate of 96.1 per cent (25 of 26) in group A and 83 per cent (15 of 17) in group B. There was no statistically significant difference between the results of the two groups (chi-square test: p = 0.31).ConclusionThere was no statistically significant difference in the results of cerebrospinal fluid leak repair with and without fibrin glue.

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