Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

This study was designed to compare the postoperative outcomes of bicanalicular intubation using different diameters of silicone tubes to treat post-saccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with post-saccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. The patients were divided into two groups; those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The patency rates of the two groups at one year after tube removal were compared using the Kaplan–Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results showed that the recurrence rate after tube removal was significantly lower in the LD group compared to the ND group (p = 0.001). The patency rates at one year after removal in the LD and ND group were 0.857 (0.754-0.919) and 0.739 (0.617-0.828), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

This study was designed to compare the postoperative outcomes of bicanalicular intubation using different diameters of silicone tubes to treat post-saccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with post-saccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. The patients were divided into two groups; those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The patency rates of the two groups at one year after tube removal were compared using the Kaplan–Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results showed that the recurrence rate after tube removal was significantly lower in the LD group compared to the ND group (p = 0.001). The patency rates at one year after removal in the LD and ND group were 0.857 (0.754-0.919) and 0.739 (0.617-0.828), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

This study was designed to compare the postoperative outcomes of bicanalicular intubation using different diameters of silicone tubes to treat post-saccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with post-saccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. The patients were divided into two groups; those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The patency rates of the two groups at one year after tube removal were compared using the Kaplan–Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results showed that the recurrence rate after tube removal was significantly lower in the LD group compared to the ND group (p = 0.001). The patency rates at one year after removal in the LD and ND group were 0.857 (0.754-0.919) and 0.739 (0.617-0.828), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were significantly higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

Sonographic Measurement and Sex Variability of Portal Vein Using US scan in a sample of Sudanese Adults

Background: Measurements of the normal portal venous dimension in a specified population is so crucial. portal vein can be measured by several methods for assessing different parameters, Computed topography (CT) and sonographic imaging are common examples. The diagnosis of portal hypertension depends on the transverse portal vein diameter (normal diameter from 6-15 mm). The aim of this study is to establish baseline value for the portal vein diameter and assess the correlation with age, gender, weight, height and BMI in Sudanese populations.Methodology: This was a descriptive cross-sectional study that included a sample of Sudanese adults who were requested to have routine abdominal sonographic scanning due to reasons not related to liver or portal vein problems. The study was carried out at the Radiology Department of Qatar Alnada Hospital, Umbadda, Khartoum, Sudan 2020.Results: In this study, 376 participants were included of which more than half were females (56.1%, n=211), while 165(43.9%) were males. The mean age of the participants was 38.12 + 15.57 years. The mean portal vein diameter was 10.79 + 1.27 millimeters. From this study the portal vein diameter varied with age (p value = 0.000), weight (p value = 0.002), height (p value = 0.000) and gender (p value = 0.000). It is not related to BMI (p value = 0.3).Conclusion: This study has revealed that the portal vein diameter has positive correlation with age, gender, height, and weight of the person and has no correlation with the BMI.

Advances in the Treatment of Gastrointestinal Bleeding: Safety and Efficiency of Transnasal Endoscopy

Acute upper gastrointestinal bleeding (UGIB) is a common disorder and a gastroenterological emergency. With the development of new techniques and devices, the survivability after gastrointestinal bleeding is improving. However, at the same time, we are facing the difficulty of severely complicated cases with various diseases. For example, while endoscopic examination with a normal diameter endoscope is essential for the diagnosis and treatment of UGIB, there are several cases in which it cannot be used. In these cases, transnasal endoscopy (TNE) may be a viable treatment option. This report reviews current hemostatic devices for endoscopic treatment and the safety and efficiency of using TNE in complicated cases. The latter will be demonstrated in a case report where TNE was employed in a patient with severe esophageal stenosis. This review summarizes the advances made in the devices used and will provide further ideas for the physician in terms of combining these devices and TNE.

Extraocular muscle diameter in Makurdi, North Central Nigeria: what is normal?

Background: Establishing normal values of extra ocular muscle (EOM) diameter is essential in a given population. Factors including race, region, gender and environment affect the normal diameter of the EOM. The aim of the study was to determine the normal sizes of the EOM in a population in the North Central part of Nigeria using computed tomography (CT).Methods: One hundred and eighty-three CT images of patients who underwent craniofacial imaging for other conditions and who met the inclusion criteria were evaluated. The maximum diameters of the EOMs on coronal reformatted CT images which are the superior group (SG) (superior rectus and the levator palpebral), inferior rectus (IR) medial rectus (MR) and lateral rectus (LR) were assessed.Results: The mean values±SD obtained were 3.65±1.13, 3.93±0.94, 3.40±0.67, 3.43±0.92 for SG, 1R, MR, and LR muscles respectively on the right and 3.61±1.07, 3.86±0.92, 3.34±0.70, 3.42±0.08 for SG, IR MR and LR muscles respectively on the left. The order IR>SR>MR>LR of average muscle diameter was obtained. The females in this region showed slightly higher mean values of the diameter of the EOM than the males; however, this was not statistically significant. By age, there was no consistent correlation.Conclusions: The established normal values of the EOM may serve as a reference point for ophthalmologist and for cosmetic surgeons and also will add to the pool of the existing knowledge for academic purposes.

Linear plication and external wrapping in ascending aortic aneurysm in well-selected patients: Surgical technique

An aortic aneurysm is known as a bulging or dilatation of the aorta for more than one and half of its normal diameter result in making the wall of the aorta thinner and at the risk of dissection or rupture. For a long time ago surgeons have worked hard to find the best surgical technique to treat this pathology. Open surgery with the replacement of the aneurysmatic segment by a synthetic graft is still the standard surgical treatment method. In the past, some surgeons tried patching the aneurysmatic segment with synthetic patches. This technique was not accepted by many surgeons. In our cardiovascular surgical center, we perform linear plication and external wrapping (LPEW) surgical technique for more than ten years in well-selected patients whose aortic aneurysm diameter is less than 6 cm with normal aortic root and who has not any connective tissue disease, dissection, or rupture. Our results are satisfying with low morbidity and mortality.

Leaflet Dimensions as a Guide to Remodeling Annuloplasty During Aortic Valve Repair

Objective In chronic aortic insufficiency (AI), the method and degree of annular downsizing required to achieve durable coaptation in aortic valve repair (AVr) remains poorly defined. This study evaluated the relationship between leaflet size and annular diameter to predict adequate annular sizing in remodeling AVr. Methods Under regulatory supervision, 74 patients with chronic tri-leaflet AI underwent AVr using ring annuloplasty and leaflet reconstruction. Fifty-four (73%) had ascending aortic ( n = 25) and/or root ( n = 29) aneurysms, and aortic grafts were sized 5 to 7 mm larger than the rings. Intraoperatively, leaflet free-edge length (FEL) was measured with special ball sizers positioned in the coronary sinus, and “normal” annular diameter was predicted from the validated formula: Required “normal” diameter = FEL/1.5. “Normal” annular diameters predicted from FEL were compared with pathologic diameters measured intraoperatively with Hegar dilators, and both were correlated with gender, age, and BSA. Results Average age was 62.1 ± 13.3 years (mean ± SD), 73% (54/74) were male, and 96% (71/74) had moderate-to-severe AI. All patients had annular dilatation, with a pathologic diameter 26.6 ± 2.3 mm before repair, and a predicted “normal” diameter of 21.7 ± 1.7 mm ( P < 0.001). Both predicted and pathologic annular diameters were larger in men ( P < 0.001), but no relationship existed with age. BSA correlated with both predicted and pathologic diameters, although variability was large. Conclusions Based on a simple validated method to predict “normal” annular diameter, all patients with chronic AI have some degree of annular dilatation. This finding implies that most AVr should include annuloplasty, with adequate and precise annular reduction based on leaflet size.

Hemodynamic-Based Evaluation on Thrombosis Risk of Fusiform Coronary Artery Aneurysms Using Computational Fluid Dynamic Simulation Method

Coronary artery aneurysms (CAAs) have been reported to associate with an increased risk for thrombosis. Distinct to the brain aneurysm, which can cause a rupture, CAA’s threat is more about its potential to induce thrombosis, leading to myocardial infarction. Case reports suggest that thrombosis risk varied with the different CAA diameters and hemodynamics effects (usually wall shear stress (WSS), oscillatory shear index (OSI), and relative residence time (RRT)) may relate to the thrombosis risk. However, currently, due to the rareness of the disease, there is limited knowledge of the hemodynamics effects of CAA. The aim of the study was to estimate the relationship between hemodynamic effects and different diameters of CAAs. Computational fluid dynamics (CFD) provides a noninvasive means of hemodynamic research. Four three-dimensional models were constructed, representing coronary arteries with a normal diameter (1x) and CAAs with diameters two (2x), three (3x), and five times (5x) that of the normal diameter. A lumped parameter model (LPM) which can capture the feature of coronary blood flow supplied the boundary conditions. WSS in the aneurysm decreased 97.7% apparently from 3.51 Pa (1x) to 0.08 Pa (5x). OSI and RRT in the aneurysm were increased apparently by two orders of magnitude from 0.01 (1x) to 0.30 (5x), and from 0.38 Pa−1 (1x) to 51.59 Pa−1 (5x), separately. Changes in the local volume of the CAA resulted in dramatic changes in local hemodynamic parameters. The findings demonstrated that thrombosis risk increased with increasing diameter and was strongly exacerbated at larger diameters of CAA. The 2x model exhibited the lowest thrombosis risk among the models, suggesting the low-damage (medication) treatment may work. High-damage (surgery) treatment may need to be considered when CAA diameter is 3 times or higher. This diameter classification method may be a good example for constructing a more complex hemodynamic-based risk stratification method and could support clinical decision-making in the assessment of CAA.