scholarly journals Education in plastic surgery: Are we headed in the right direction?

2014 ◽  
Vol 47 (01) ◽  
pp. 109-115 ◽  
Author(s):  
Nishant Khare ◽  
Vinita Puri
Keyword(s):  
Plastic Surgery ◽  
Statistical Significance ◽  
Maxillofacial Surgery ◽  
Aesthetic Surgery ◽  
Microvascular Surgery ◽  
Chi Square ◽  
Surgery Group ◽  
Group I ◽  
Group Ii ◽  
And Training

ABSTRACT Introduction: Plastic surgery in India is in an era of transition. The speciality faces many challenges as it grows. The present study attempts to identify these challenges and the prevalent mood among the teachers and the trainees. Materials and Methods: The study was conducted from September 2011 to June 2012. In an E-mail based survey a questionnaire was mailed to professionals actively involved in teaching and training of residents in plastic surgery in many institutes running MCh courses in plastic surgery (Group I) [Appendix 1]. Another questionnaire was mailed to residents undergoing training in plastic surgery and those who had completed their training within past 2 years (Group II) [Appendix 2]. Chi-square test was applied to test for statistical significance. Observations: 29 Group I and 33 Group II subjects responded to the questionnaire. While 72.4% teachers believed that the current system is producing plastic surgeons with enough skill level, only 9.1% of the respondents in Group II thought the same (Chi-square = 28.1; df = 2; P < 0.001). Whereas 58.6% Group I respondents thought that their student is sufficiently equipped to compete in today’s scenario [Figure 1], only 18.2% Group II respondents thought that their training is enough [Figure 2]. (Chi-square = 16.4; df = 2; P < 0.001). Nearly 28% respondents in Group I and only 3% in Group II thought that scientific research and publications should be made mandatory for successful completion of plastic surgery training (Chi-square = 9.4; df = 2; P = 0.009). Adequate exposure was thought to be available in general plastic surgery (Group I: 92% Group II: 81%), maxillofacial surgery (Group I: 72% Group II: 68%) and hand surgery (Group I: 84% Group II: 69%). Both groups agreed that exposure is lacking in craniofacial surgery, aesthetic surgery and microvascular surgery. Aesthetic surgery (38.7%) and microvascular surgery (32.6%) were the most frequent response when the Group II respondents were enquired about the subspeciality they would like to focus on in their practice. Inter-departmental exchange of students for limited period of time was favoured by 86.2% of Group I respondents and 93.9% Group II respondents (Chi-square = 1.3; df = 2; P = 0.49). Conclusion: The current training programme is differently perceived by teachers and the trainees. We recommend that constant deliberations at national and regional forums should take place regarding our education and training programmes.

scholarly journals Comparison of Uncomfortable Loudness Level in Stapedotomy with or without Stapedial Tendon Preservation

2021 ◽  
Vol 27 (2) ◽  
pp. 117-123
Author(s):  
Tamanna Nawshin ◽  
Kanu Lal Saha ◽  
Shah Sohel ◽  
Sabyasachi Talukdar ◽  
Sheikh Mohammad Tanjil Ul Alam
Keyword(s):  
Statistical Significance ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Group I ◽  
Loudness Level ◽  
Group Ii

Background: Otosclerosis is one of the commonest diseases of the ear mostly involves the otic capsule. Most often otosclerotic foci appear in stapes region leading to stapes fixation, predominantly affect the adolescence female. The most common presenting symptom of clinical otosclerosis is conductive deafness. The mainstay of treatment for otosclerosis is surgery. Surgical options include stapedectomy, stapedotomy with or without stapedial tendon preservation. The latter being is the procedure of choice. Aim: The aim of this study is to compare the outcome of uncomfortable loudness level in stapedotomy with or without stapedial tendon preservation. Methods: A prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months in patients with otosclerosis. Total 30 subjects were selected based on the inclusion and exclusion criteria. All patients were assessed pre-operatively by clinical examination, otoscopy and microscopic examination. Hearing was assessed by pure tone audiometry. Uncomfortable level and stapedial reflex threshold were tested in all cases. The selected cases were placed into two groups. Stapedial tendon resection in Group-I and stapedial tendon preservation in Group-II. Post-operative follow up was done at 3 months and 6 months. Hearing and uncomfortable loudness level were evaluated with PTA during follow up by calculating the average of 500Hz, 1000Hz, 2000Hz and 4000HZ. The data were calculated manually. The statistical significance was set to P< 0.05. Results of the study were expressed as mean, standard deviation (± SD), frequency and percentages. Means and standard deviations were reported for continuous variables. Frequencies and percentages were reported for categorical variables. Unpaired Student’s t test was done to compare the continuous variables and Chi Square test was done to compare the categorical variables. Results: In this study preoperative average ABG for group I and group II were 35 ± 4.57 dB and 34 ± 4.17 dB respectively. In group I, post operative average ABG after 3 months and 6 months were 14 ± 3.7 dB and 13±3.3 dB respectively. Post operative average ABG after 3 months was 13 ± 5.7 dB and was 12 ± 4.4 dB for group II. But the hearing improvement between two groups was not statistically significant. In case of preoperative mean UCL was 95 ± 1.8 dB and 96 ± 2.5 dB for group I and group II respectively. Postoperative mean UCL after 3 months was 96 ± 3.57 dB and after 6 months was 99 ± 6.28 dB in group I. For group II, postoperative mean UCL after 3 months and 6 months was 107±4.2 dB and 113 ± 3.2 dB respectively. Here mean UCL was on average 11 dB higher for group II in 3 months and additional 6 dB improvement noted after 6 months, but show minimal change in group I. This finding was statistically significant. Conclusion: Preservation of the stapedial tendon is the choice in the surgical treatment of otosclerosis which helps to improve functional outcomes as well as to provide the more physiologic protection of middle ear. Postoperative discomfort threshold levels were increased in patients who had their stapedial tendon restored. Bangladesh J Otorhinolaryngol 2021; 27(2): 117-123

scholarly journals TREATMENT OF ACUTE LUMBAGO

2008 ◽  
Vol 15 (04) ◽  
pp. 440-444
Author(s):  
TAHIR AHMAD KHAN ◽  
ASHER AHMAD ◽  
IRFAN ZAFAR HAIDER
Keyword(s):  
Pain Relief ◽  
Statistical Significance ◽  
Diclofenac Sodium ◽  
Vitamin B ◽  
Duration Of Treatment ◽  
Chi Square ◽  
Group I ◽  
Group Ii ◽  
Pain At Rest ◽  
Acute Lumbago

Objective: To determine whether concomitant use of vitamins B1, B6, B12 along with low dose of diclofenac sodium causesquicker pain relief in patients of acute lumbago compared with diclofenac sodium alone. Design: A randomized clinical trial. Setting: SurgicalDepartment of C M H Attock. Period: From September 2004 to August 2005 Patients & Methods: A total of 50 patients were selected forthe study. The patients complaints were of acute lumbago of less than 3 days duration with severe impairments of movements. The age groupof patients was between 20 and 65 years. The patients were randomly assigned into two groups. Group I was prescribed tablet diclofenacsodium 25mg along with vitamin B-complex containing combination of 100mg thiamine nitrate (B1), 100mg pyridoxine hydrochloride (B6), and200mcg cyanocobalmine (B12) three times a day. Group II patients were prescribed 25mg of tablet diclofenac sodium alone. Improvement inthe intensity of pain at rest and during movements (as assessed by the patients) was noted in accordance to visual analogue scale 1 to 10.The effectiveness of diclofenac sodium in combination with vitamin-B complex with diclofenac sodium alone was judged on the basis of extentof pain relief after 7 days of treatment. Results: A total of 25 patients were treated with combination of diclofenac sodium & vitamin-B complex(Group I) and 25 were treated with diclofenac sodium alone (Group II). As far as the extent of pain relief in first 7 days is considered, 22 patients(88%) belonging to group I and 10 patients (12%) belonging to group II had an excellent pain relief and were able to carry on with their normalroutine activities. Remaining 3 patients in group I were completely relieved of pain in next 3 days while 15 patients in group II had to completeanother 10 days for complete cure. To test the statistical significance of the result chi-square test was applied and the result showed thatpatients of Group I responded significantly well to the treatment as compared to those in Group II. Conclusion: Using the parameters of painrelief and movements of vertebral column, the combination of diclofenac sodium & vitamin-B complex was found to be more effective modeof treatment as the duration of treatment and the dosage of diclofenac sodium was less and also relief of pain was more rapid.

Bridging the gap between perioperative pelvic floor training and urologic surgeries with risk of incontinence by digital technologies: a survey. (Preprint)

2020 ◽  
Author(s):  
Jan Niclas Mumm ◽  
Lucas Bohn ◽  
Lennert Eismann ◽  
Alexander Buchner ◽  
Theresa Vilsmaier ◽  
...  
Keyword(s):  
At Risk ◽  
Pelvic Floor ◽  
Digital Technologies ◽  
Preventive Treatment ◽  
Final Analysis ◽  
Chi Square ◽  
Group Iii ◽  
Pelvic Floor Training ◽  
Group I ◽  
Group Ii

BACKGROUND Pelvic floor training (PFT) is the gold standard for conservative treatment of male stress urinary incontinence. OBJECTIVE To evaluate patients´ perspective at risk of incontinence on PFT and application of digital technologies for PFT. METHODS Patients undergoing transurethral surgery of the prostate (group I), radical prostatectomy (group II) or treatment at a specialized incontinence outpatient clinic (group III) were surveyed anonymously. Chi-Square test and Kruskal-Wallis-analysis were used for statistical analysis. RESULTS 180 patients were included in the final analysis. In group I (n=35) no patient underwent PFT prior to transurethral surgery. 23.5% of patients in group II (n=51) and 95.7% of patients in group III (n=94) performed PFT. 11.4% in group I, 80.4% in group II and 91.5% in group III have been advised to perform PFT by their urologist. Regarding the information level on PFT, patients from group I (median 1, range 0-5) are less satisfied than patients from group II (median 3, 0-9) or group III (median 5, range 0-10, p<0.001). 88.6% of patients from group I are willing to perform PFT as preventive treatment or to avoid incontinence surgery, 100% from group II and 68.4% from group III (p<0.001). The likelihood to use digital PFT is higher in group I (median: 9, range 0-10) and II (median: 9, range 0-10) than in group III (median: 4, range 0-10, p<0.001). CONCLUSIONS Patients at risk of incontinence currently have limited access to PFT, although they are willing to perform PFT. Digital PFT is highly accepted by patients preoperatively and might be a valuable tool to increase PFT participation.

A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA

2021 ◽  
pp. 48-50
Author(s):  
Niraj Kumar Mishra ◽  
Sushil Kumar
Keyword(s):  
Side Effects ◽  
Fetal Distress ◽  
Labour Pain ◽  
Sampling Procedure ◽  
Chi Square ◽  
Double Blind ◽  
Motor Weakness ◽  
Group I ◽  
Group Ii ◽  
Fetal Oxygenation

Introduction: Labour pain is among the most severe pain a woman can experience in her lifetime. Painful labour has decrimental effects on both mother and fetus leads to severe physical and psychological stress. Maternal hyperventilation in response to pain reduces fetal oxygenation and hypoventilation between contractions combined with decreased blood ow worsens fetal hypoxemia. It has been suggested that conning women to bed during labour may cause the labour to be longer and more painful with increase in abnormal presentation, instrumental deliveries and fetal distress. Aims And Objectives:The onset, quality and duration of their analgesic action. Incidence of unwanted effects like muscle weakness, hypotension, pruritus, nausea/vomiting, fetal bradycardia by the individual drugs. Materials And Methods: The study was conducted in the department of anesthesia, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Methods of collection of data (including sampling procedure if any) : After institutional committee approval and written informed consent from parturients and their relatives for the procedure the study was conducted and data were collected. Results: Duration of analgesia was found varying widely. It was 55±12.34 minutes in Group I whereas 75 ±14.36 minutes in Group II. The incidence of pruritus almost mild or negligible in both groups. The incidence of motor weakness in group II was 24 (80%) whereas in group I it was 10(33%). There was signicant statistics difference in motor weakness between two groups (p< 0.001) by Chi square test 9 with yate's correction. Other side effects differences between two groups were not statistically signicant. Summary And Conclusion:Both the drugs provided excellent quality of analgesia to the parturient in pain. The difference in duration of analgesia was signicant between the two groups statistically. Mean duration of analgesia lasted for 55 minutes in group I whereas in group II, it lasted for 75 minutes. Main side effects encountered in this study were motor weakness of longer duration in group II than in group I. Other side effects like nausea-vomiting were comparable to each other and were minimal in nature.

To Compare Frequency of Sore Throat in Early Postop period in General Anesthesia and Endotracheal Intubation for Abdominal Surgeries who are given Dexamethasone and Normal Saline

2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat
Keyword(s):  
General Anesthesia ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Controlled Study ◽  
Control Group ◽  
Chi Square ◽  
Group I ◽  
Chi Square Test ◽  
Group Ii

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia

Comparison of a PGA Sheet with a Commercial ePTFE Sheet as a Staple-Line Reinforcement in Lung Surgery

2007 ◽  
Vol 342-343 ◽  
pp. 849-852
Author(s):  
Keon Hyeon Jo ◽  
Seok Whan Moon ◽  
Young Du Kim ◽  
Young Jo Sa ◽  
Si Young Choi ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Polyglycolic Acid ◽  
Lung Surgery ◽  
Resection Margins ◽  
Air Leakage ◽  
Staple Line Reinforcement ◽  
Group I ◽  
Significant Difference ◽  
Similar Threshold ◽  
Group Ii

To prevent prolonged air leakage after lung surgery, we developed a biodegradable polyglycolic acid (PGA) sheet and compared it with an expanded polytetrafluoethylene (ePTFE). Eighteen adult mongrel dogs were used in this experiment. The airway pressures at which air first leaked at the stapled resection margins were measured immediately after surgery in group I (N=5), 2 days after surgery in group II (N=5), and 7 days after surgery in group IIII (N=5), Based on the presence of SLR, there were 3 subgroups in each group: there was no SLR in subgroup a; ePTFE in subgroup b; PGA sheet in subgroup c. The histologic examination was performed 2 months after surgery (N=3). In group I, there was a significant difference in air leakage pressures (mm Hg) between no reinforcement and SLR. We observed the same results in group II and III with statistical significance. However, there was no significant difference between the reinforcement groups. The histologic findings demonstrated more severe adhesions and biodegradation in the dogs in which the PGA sheet was used. Our PGA sheet was considered a useful reinforcement material, because it had a similar threshold for air leakage with the ePTFE with excellent biodegradation.

Ventilation and thoracoabdominal asynchrony during halothane anesthesia in infants

1993 ◽  
Vol 74 (4) ◽  
pp. 1591-1596 ◽  
Author(s):  
M. Benameur ◽  
M. D. Goldman ◽  
C. Ecoffey ◽  
C. Gaultier
Keyword(s):  
Tidal Volume ◽  
Minute Ventilation ◽  
Statistical Significance ◽  
Age Group ◽  
Halothane Anesthesia ◽  
Minimal Alveolar Concentration ◽  
Group I ◽  
Wall Compliance ◽  
Group Ii ◽  
Thoracoabdominal Asynchrony

To evaluate the ventilatory consequences of high chest wall compliance during anesthesia in infants, we assessed the effects of halothane at different fractions of minimal alveolar concentration (0.75, 1.0, and 1.5 MAC) on ventilation and movements of the rib cage and abdomen in infants < or = 12 mo of age (group I) and children (group II) > or = 12 mo of age. Minute ventilation decreased in group I, (20.6%, 0.75 to 1.5 MAC), but the change in group II did not reach the level of statistical significance. Tidal volume decreased with halothane level between 0.75 and 1.5 MAC, and its fall was greater in group I (32.7 +/- 11.2 vs. 22.6 +/- 9.3% in group II, P < 0.05). Duty cycle, or ratio of inspiratory to total time (TI/TT), increased in group II with halothane level but did not change in group I, resulting in a decreased TI in group I at higher halothane levels. Thoracic paradox increased with halothane level in group I but not group II. The increase in thoracic paradox in association with the fall in tidal volume between 0.75 and 1.5 MAC was greater in group I than group II (P < 0.05). We conclude that smaller infants depend more on inspiratory intercostal muscle activity to stabilize the thorax, leading to a greater degree of depression of ventilation during halothane depression of inspiratory intercostal activity.

scholarly journals Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team

2015 ◽  
Vol 42 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Daniel Francisco Mello ◽  
José Cesar Assef ◽  
Sílvia Cristine Soldá ◽  
Américo Helene Jr
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Skin Flap ◽  
Length Of Hospital Stay ◽  
Lower Limbs ◽  
Trauma Patients ◽  
Early Assessment ◽  
Group I ◽  
Group Ii ◽  
Degloving Injuries

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>

scholarly journals Influence of apical foramen cleaning in the repair of periapical lesions

2011 ◽  
Vol 52 (1/3) ◽  
pp. 45-47
Author(s):  
Carolina Dos Santos Guimarães ◽  
Gerhilde Callou Sampaio ◽  
Élvia Barros de Almeida ◽  
Luciano Barreto Silva ◽  
Ana Paula Mourato ◽  
...  
Keyword(s):  
Root Canal ◽  
Endodontic Treatment ◽  
Periapical Lesion ◽  
Chi Square ◽  
Periapical Lesions ◽  
Group I ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group Ii ◽  
One Year

Introduction: The present study sought to assess the effect of apical foramen cleaning in the repair of periapical lesions detected by radiography. Methods: The sample comprised 980 teeth collected from 25 February 1997 to 15 March 2005 which had been subjected to endodontic treatment and exhibited radiographically visible periapical lesions. The sample was then divided into two groups: Group I, 402 root canal treatments in which cleaning of the apical foramen had not been performed, and Group II, composed of the remaining 578 root canal treatments where the procedure had been performed. After one year, the teeth were clinically and radiographically evaluated. Results: In Group I, 360 canals (89.55%) had no evidence of periapical lesions, versus 521 (90.13%) in Group II. Partial presence of these lesions was observed in 23 canals (5.72%) in Group I versus 27 (4.67%) in Group II. No changes in images were observed in 19 (4.72%) canals in Group I and 30 in Group II. Pearson’s chi-square test showed no statistically significant difference between the Groups I and II (p = 0.732). Conclusions: These findings suggest that foramen cleaning is not a determinant of periapical lesion repair.

scholarly journals Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population

2021 ◽  
Vol 18 (21) ◽  
pp. 11491
Author(s):  
Alexandra Matei ◽  
Elena Poenaru ◽  
Mihai Cornel Traian Dimitriu ◽  
Cristina Zaharia ◽  
Crîngu Antoniu Ionescu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Vaginal Birth ◽  
Adult Women ◽  
Young Mothers ◽  
Soft Tissue Trauma ◽  
Chi Square ◽  
Perineal Lacerations ◽  
Group I ◽  
Group Ii ◽  
Tissue Trauma

Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.

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