scholarly journals Total Endoscopic Transcanal Cartilage Myringoplasty: A Prospective Study

2019 ◽  
Vol 23 (04) ◽  
pp. e440-e444
Author(s):  
Dipesh Shakya ◽  
Arun KC ◽  
Ajit Nepal ◽  
Nirmala Tamang
Keyword(s):  
Prospective Study ◽  
Chronic Otitis Media ◽  
Endoscopic Approach ◽  
Closure Rate ◽  
Hearing Results ◽  
A Prospective Study ◽  
Lost To Follow Up ◽  
Air Conduction ◽  
Hearing Evaluation

Introduction Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods This is a prospective study. We have analyzed 139 patients who underwent surgery for chronic otitis media (COM) of the mucosal type. All of the surgeries were performed exclusively under total endoscopic transcanal approach using tragal cartilage as graft, underlay technique. We have evaluated the postoperative graft uptake and performed a hearing evaluation at 6 weeks, at 12 weeks, and at 6 months. Results During the study period, 139 patients were included, out of which 13 were lost to follow-up; therefore, only 126 patients were assessed. All of the cases were performed under total endoscopic approach. As for the surgical outcome at the postoperative otoscopy, 3 cases had initial uptake at 3 months and failed later; therefore, complete closure of the perforation was observed in 97.6% (n = 123) of the patients 6 months after the intervention.Four patients presented with preoperative anacusis; therefore, only 122 patients were included for hearing evaluation. The preoperative air conduction threshold (ACT) and airbone gap (ABG) were 43.34 ± 11.53 and 24.73 ± 7.89, respectively.Postoperatively, the ACT and ABG closure were 28.73 ± 15.75 and 11.91 ± 8.41, respectively. This difference was statistically significant (p < 0.001). Conclusion The endoscopic approach for myringoplasty offers excellent visualization; avoids postaural approach, enables a faster recovery, requires less hospital stay, with excellent graft closure rate and improved functional outcomes.

The management of quinsy—a prospective study

1992 ◽  
Vol 106 (11) ◽  
pp. 986-988 ◽  
Author(s):  
C. R. Chowdhury ◽  
M. C. M. Bricknell
Keyword(s):  
Prospective Study ◽  
Significant Saving ◽  
Incision And Drainage ◽  
The Social ◽  
Student’S T ◽  
A Prospective Study ◽  
Abscess Tonsillectomy ◽  
Lost To Follow Up ◽  
Student’S T Test

AbstractA prospective study for the treatment of quinsy was undertaken between January 1989 and September 1991. This was to determine whether abscess tonsillectomy reduces inpatient stay without increasing operative risk compared to incision and drainage combined with interval tonsillectomy. Fifty-three patients were entered into the study. Twenty-one had abscess tonsillectomy and 32 had incision and drainage. This study showed that there is a 95 per cent probability that abscess tonsillectomy reduces hospital stay by between 2.04 and 4.84 (Student's t test t = 5.01; df = 31, p<0.001) days compared to incision and drainage followed by interval tonsillectomy. This is a significant saving in time and resources. Abscess tonsillectomy reduces patients lost to follow-up, avoids the social inconvenience of a second admission, effectively relieves symptoms, treats a contralateral abscess and is the only method of treating children with a quinsy. We recommend abscess tonsillectomy should be performed for quinsy where expertise and facilities are available.

scholarly journals A prospective study of efficacy and safety of mifepristone and vaginal misoprostol in termination of pregnancy up to 63 days of gestation

2017 ◽  
Vol 6 (2) ◽  
pp. 567
Author(s):  
Mahima Jain ◽  
Sonali Sharma
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Common Adverse Effect ◽  
Reproductive Age ◽  
Illegal Abortion ◽  
Participation Motivation ◽  
Vaginal Misoprostol ◽  
A Prospective Study ◽  
Lost To Follow Up

Background: Illegal abortion is still one of the important causes of maternal mortality in India accounting for approximately 13%. Medical Management of abortion is a non-surgical termination which does not require special facilities like operation theatre, hospital stay and thereby reduces complications associated with the same.Methods: It is a prospective study done in a Tertiary care Government Hospital over a span from Jan 2015 to April 2016. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. In first visit Tab. mifepristone 200 mg. orally was given and advised to take Tab. misoprostol 800 mcg. Vaginally after 48 hours at home. They were counselled for side effects and asked to report in case of excess bleeding, pain, fever or no bleed for 24 hours of misoprostol. After 7 days follow up was done to ensure completion of abortion. Any additional drugs required were noted. Contraceptive advice is also given during these visits.Results: In our study 60 cases were taken. Majority of women are between 20-29 years of age which is peak reproductive age. 61.1% women are of second parity. The success rate of medical methods is 96.6%, two cases out of 60 underwent surgical evacuation and one was lost to follow up. Most common adverse effect noted is abdominal cramps. No patient required hospitalization. Additional Misoprostol was required in 4 cases. This method is highly acceptable 95% cases as it is non invasive and preferred to adopt the same in future if needed.Conclusions: Patient participation, motivation, compliance, regular follow up visits, ability to record and report complications are the pillars on which the success of medical methods depends. Hence overall, it came out to be safe and effective method.

scholarly journals A Prospective Study of Posterior (Transpedicular) Approach versus Anterior (Transthoracic/Thoracoabdominal) Approach for Posttraumatic Compression Fracture of Thoracolumbar Vertebra in a Tertiary Care Center: Comparison of Clinical and Radiological Outcomes

2020 ◽  
Author(s):  
Rahul Varshney ◽  
Parthasarathi Datta ◽  
Pulak Deb ◽  
Santanu Ghosh
Keyword(s):  
Prospective Study ◽  
Posterior Approach ◽  
Spinal Injuries ◽  
Anterolateral Approach ◽  
Kyphotic Angle ◽  
Posterior Group ◽  
Thoracoabdominal Approach ◽  
A Prospective Study ◽  
Anterior Group

Abstract Objective The aim of this article was to analyze the clinical and radiological outcomes of transpedicular decompression (posterior approach) and anterolateral approach in patients with traumatic thoracolumbar spinal injuries. Methods  It was a prospective study of patients with fractures of dorsolumbar spine from December 2011 to December 2013. A total of 60 patients with traumatic spinal injuries were admitted during the study period (December 2011–2013), of which 51 cases were finally selected and taken for operations while 3 were eventually lost in follow-up. Twenty patients were operated by anterolateral approach, titanium mesh cage, and fixation with bicortical screws. Twenty-eight patients were treated with posterior approach and transpedicular screw fixation. Clinical and radiographic evaluations were performed on all 48 patients before and after surgery. Results There were 48 patients of thoracolumbar burst fractures with 40 male and 8 female patients. Range of follow-up was from 1 month to 20 months, with a mean of 7.4. Preoperatively in anterior group, 65% of the patients were bed ridden, 20% patients were able to walk with support, and 15% of the patients were able to walk without support. In posterior group, 78.57% patients were bed ridden, 10.71% were able to walk with support, and 10.71% patients were able to walk without support. Kyphotic angle changes were seen in 16 patients out of 18 in anterior group and 20 patients in posterior group out of 25. Out of 18 patients in anterior group, 14 showed reduction in kyphotic angle of 10 to 100 (improvement), with mean improvement of 4.070. In posterior group, 7 patients showed improvement of 10 to 80 (reduction in kyphotic angle) whereas 13 patients showed deterioration of 1 to 120. The mean improvement was 2.140 in 7 patients and mean deterioration was 4.920. No statistical difference was found (p > 0.05) regarding improvement in urinary incontinence during the follow-up period. Conclusion There are significant differences in anterior and posterior approaches in terms of clinical improvement. Compared with posterior approach, the anterolateral approach can reduce fusion segment and well maintain the kyphosis correction. The selection of treatment should be based on clinical and radiological findings, including neurological deficit.

Customised gold weight eyelid implantation in paralytic lagophthalmos

2008 ◽  
Vol 122 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
N Jayashankar ◽  
K P Morwani ◽  
M J Shaan ◽  
S R Bhatia ◽  
K T Patil
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Study Design ◽  
Study Group ◽  
Upper Eyelid ◽  
Eyelid Closure ◽  
Gold Weight ◽  
One Year ◽  
A Prospective Study

AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.

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