scholarly journals Observations on the Efficacy of Two Methods for the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Dongping Li ◽  
Fengyuan Sun

Objective. To observe the clinical efficacy of periocular injection of triamcinolone acetonide (TA) and subpalpebral injection of botulinum toxin type A (BTXA) for the treatment of thyroid-associated ophthalmopathy (TAO) with mild unilateral upper eyelid retraction. Method. This was a prospective randomized controlled study. A total of 68 cases of stable thyroid-associated ophthalmopathy with mild upper eyelid retraction were collected at Hankou Aier Eye Hospital from Jan. 2015 to Dec. 2018 and randomly divided into two groups. Group A contained 33 patients who were administered TA by periocular injection once every 3 weeks for a total of 3 times. Group B contained 35 patients who were given a single subpalpebral administration of BTXA. The efficacy in the two groups was observed. Results. Compared with the two groups, the effective rate in both groups was 100% at 1 week and 1 month after treatment. The effective rate of Group A remained 100% at 3 months after treatment, and that of Group B decreased to 88.6%. At 1 week after treatment, the degree of correction in Group B was greater than that in Group A ( p < 0.001 ). At 1 month after treatment, it was not significantly different between the two groups ( p > > > 0.05 ). At 3 months after treatment, it was less in Group B than in Group A ( p < 0.001 ). In Group A, there was one case of transient amaurosis, two cases of periorbital hemorrhage and swelling, and one mild case of sunken eyes. In Group B, four cases experienced recurrence after 3 months. Conclusion. Periocular injection of TA and subpalpebral injection of BTXA offer definite therapeutic efficacy for mild upper eyelid retraction associated with thyroid disease. The former has a long treatment period, large procedural risks, and stable efficacy. The latter is a simple procedure with a short treatment period but can easily recur.

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Pengfei Sang ◽  
Mingsong Fang ◽  
Xuan Li ◽  
Chang Liu ◽  
Qingchun Xi

Objective. To explore the role of conjoint fascial sheath (CFS) suspension in the treatment of severe ptosis. Methods. A total of 110 patients with severe ptosis who were admitted to our hospital from May 2018 to December 2020 were included. Fifty-seven patients treated with frontalis suspension were assigned into group A, and the remaining 53 patients treated with CFS suspension were assigned into group B. The curative effect, ocular surface alterations, complications, and satisfaction in the two groups were compared. Results. Patients in group B suffered from severe upper eyelid retraction and lid lag than those in group A, as well as more limited range of motion (ROM) ( P < 0.05 ). The curative effect and patient satisfaction in group B were higher than those in group A ( P < 0.05 ). Postsurgical complications in group B were fewer than those in group A ( P < 0.05 ). Conclusion. CFS suspension is effective in the treatment of severe ptosis.


2021 ◽  
Vol 62 (8) ◽  
pp. 1015-1021
Author(s):  
Ja Young Oh ◽  
Jeong Kyu Lee

Purpose: We analyzed factors that affect the outcome of levator recession surgery for upper eyelid retraction in patients with thyroid-associated ophthalmopathy.Methods: Retrospective analysis was performed based on the medical records of 24 patients with thyroid-associated ophthalmopathy who underwent upper eyelid levator recession surgery between February 10, 2010, and September 18, 2018. The margin to reflex distance (MRD), length and area of the upper and lower eyelids were measured and compared with the eyelid analysis software before and after 6 months of surgery on medical records. In addition, factors affecting the difference in MRD1 before and after surgery were examined by multivariate linear regression analysis.Results: Twenty-four patients were included in the study. The MRD1 decreased significantly from 5.12 ± 1.26 mm before surgery to 3.48 ± 1.08 mm at 6 months after surgery (p < 0.001). All upper eyelid measurements, i.e., UEL (p < 0.001), UMA (p < 0.001), UCA (p = 0.004), and ULA (p < 0.001), were significantly decreased after surgery, while none of the lower eyelid measurements showed significant changes. Multivariate logistic regression analysis indicated that lower preoperative MRD1 was associated with the success of the surgery (odds ratio, 0.31; 95% confidence interval, 0.09-1.01).Conclusions: Levator recession surgery is an efficient surgical method that can correct the upper eyelid retraction associated with thyroid-associated ophthalmopathy.


2012 ◽  
Vol 251 (1) ◽  
pp. 261-270 ◽  
Author(s):  
Sung Jun Lee ◽  
Tyler Hyung Taek Rim ◽  
Sun Young Jang ◽  
Chan Yun Kim ◽  
Dong Yeob Shin ◽  
...  

2020 ◽  
Vol 11 (3) ◽  
pp. 3418-3423
Author(s):  
Sweety Agrawal ◽  
Shubdha Bhagat ◽  
Pratibha Deshmukh ◽  
Amol Singham

The present study was done to evaluate the ability of oral pregabalin to attenuate the pressor response to airway instrumentation in patients undergoing laparoscopic cholecystectomy under general anesthesia. Sixty-four adult patients aged between 25-55 year of either gender belonging to ASA-1 or ASA2 physical status weighing 50-70 kg were enrolled in this study. Thirty-two patients each were randomized to group A, or group B. Patients in group A received tablet Pregabalin (150mg) and those in group B received placebo orally one hour before induction of anaesthesia. Heart rate, blood pressure, and sedation were assessed preoperatively before giving the tablets and after 30 minutes, and just before induction of anaesthesia. Intraoperative, pulse rate, mean arterial pressure, ECG in the lead II, SPO2 and ETCO2 were monitored. All the above parameters were noted during laryngoscopy and intubation, 3 minutes after CO2 insufflation, and then at every 10-minute interval till the end of surgery. These parameters were also recorded after extubating the patient. The Ramsay sedation scale was used to assess the sedation at the baseline, one hour after drug intake , one hour after extubation and 4 hour after surgery. Any adverse effects in the postoperative period were recorded. The result of our study shows that pre-emptive administration of oral pregabalin 150 mg significantly reduced the pressor response at the time of laryngoscopy and intubation, after CO2 insufflation and just after extubation. We conclude that oral pregabalin premedication is effective in successful attenuation of hemodynamic pressor response to laryngoscopy, intubation and pneumoperitoneum in patients undergoing laparoscopic cholecystectomy


2007 ◽  
Vol 15 (2) ◽  
pp. 81-88 ◽  
Author(s):  
Bamini Gopinath ◽  
Cherie-Lee Adams ◽  
Reilly Musselman ◽  
Junichi Tani ◽  
Jack R. Wall

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amr Abdelaal ◽  
Mostafa Soliman ◽  
Hany Rafik ◽  
Mohamed Emam ◽  
Mohamed Mahmoud Mohamed Elsadek

Abstract Background Diabetic foot ulcers (DFUs) are the main cause of hospitalization in diabetic patients and they are considered a major worldwide health problem. Thus, there is a need to evaluate various treatment modalities. In this study we will assess the clinical efficacy of Silver nanoparticles dressing vs Standard Moist Wound Dressing (SMWD) in management of diabetic foot ulcers. Objective To compare wound outcome, limb salvage, healing time of diabetes related foot ulcers and cost effectiveness in terms of duration of hospital stay between Silver nanotechnology dressings and Standard moist wound therapy (SMWT) in management of diabetic foot ulcers. Patients and Methods This is a prospective randomized controlled study involving 34 patients with active diabetic foot ulcers, in a high volume tertiary referral vascular center. They were divided into 2 groups: 17 patients (group A) were prescribed SMWD and the other 17 patients (group B) received Silver nanoparticles wound dressing. Results Our study correlates with the study conducted by K.Suhas et al. which had observed that Silver nanoparticles wound dressing was safe and effective treatment for complex diabetic foot wounds and could lead to higher proportion of healed wounds and faster healing rates. At the end of the study, group B promised a better outcome as compared to group A. Conclusion The role of Silver nanoparticles wound dressing in healing of diabetic foot ulcers has been proposed as a novel method of manipulating the chronic wound environment in a way that it reduces bacterial burden and chronic interstitial wound fluid, increases vascularity and cytokine expression and to an extent mechanically exploiting the viscoelasticity of peri wound tissues.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amira Said Mohamed ◽  
Sherein M Abd El fattah ◽  
Safaa S Imam ◽  
Basma M Shehata

Abstract Background Phototherapy is the main method used in treatment of significant indirect hyperbilirubinemia and it reduces the risk of exchange transfusion. Hypocalcemia is one of the side effects of phototherapy due to inhibition of pineal gland via transcranial illumination, resulting in decline of melatonin secretion that further inhibits the effect of cortisol on bone calcium and ultimately increase the bone uptake. Aim To assess the effect of head covering to ameliorate hypocalcemic effect of different types of phototherapy in full term jaundiced neonates. Patients and Methods A prospective randomized controlled study that included 120 jaundiced neonates requiring phototherapy which divided into two main groups; group I (treated with lamp phototherapy) which was equally subdivided into two groups, group A (without head cover) and group B (with head cover) and group Il (treated with LED phototherapy) which was equally subdivided into group C (without head cover) and group D (with head cover). Results Head cover reduced the incidence of phototherapy induced hypocalcemia without affecting rate of decline of bilirubin on both types of phototherapy used. In lamp hypocalcemia (&lt;8mg/dl) was detected in 33.3% in jaundiced neonates without head cover which was significant higher than those with head cover 6.7%. As for LED, yet not statistically significant hypocalcemia was detected in 13.3% in jaundiced neonates without head cover, which was higher than those with head cover 3.3%. Conclusion Incidence of phototherapy induced hypocalcemia is reduced by using head cover especially while using lamp phototherapy.


2017 ◽  
Vol 7 (3) ◽  
pp. 205-211
Author(s):  
Ranjit Kumar Paul ◽  
Indrajit Kumar Datta ◽  
Habib Ahmed ◽  
Mohammad Reazul Karim ◽  
Md Nazmul Haque ◽  
...  

Background: Hepatic encephalopathy (HE) is a common problem in patients with chronic liver disease (CLD) and is characterized by diminished mentation and neuromuscular abnormalities. Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe and other countries. It is unknown whether rifaximin is effective for the treatment of hepatic encephalopathy in Bangladeshi patients.Methods: A prospective, randomized, single blind, placebo controlled study was conducted to evaluate the efficacy of rifaximin among patients with cirrhosis of liver with hepatic encephalopathy. A total sixty patients of HE fulfilling inclusion criteria were randomly enrolled among those admitted under Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD) department of BIRDEM General Hospital during August 2012 to April 2013. Patients were divided into two groups: group A (receiving Tab. rifaximin with lactulose), the total number of patients were 31(51.7%) and group B (receiving placebo with lactulose), it was 29(48.3%). Enrolled patients were followed up for 10 days or up to discharge from the hospital or death. At enrollment and at the end of treatment, gradation of HE and estimation of portosystemic encephalopathy (PSE) index was done.Results: In this study between two groups, mean age difference (p=0.404), gender difference (p=0.668) and CLD duration difference (p=0.555) were not statistically significant between two groups. At enrollment, prognostic scores e.g. Child-Turcotte-Pugh (CTP) score (p=0.489) and PSE index (p=0.934) were not significantly different between two groups. At the end of treatment, group A patients showed significantly lower HE grade (P=0.045) and PSE index (P<0.05) than group B. CTP score (p=0.552) was also lower in rifaximin treated group than placebo group but no significant difference was observed. The mean duration of hospital stay was significantly lower in group A than group B (p<0.05).Conclusions: Hepatic encephalopathy patients treated with rifaximin plus lactulose have better outcome and less hospital stay than those treated with placebo plus lactulose.Birdem Med J 2017; 7(3): 205-211


2010 ◽  
Vol 8 (3) ◽  
pp. 281-284
Author(s):  
Mariana Varkala Lanuez ◽  
Fernanda Varkala Lanuez ◽  
Eduardo Gunther Montero ◽  
Wilson Jacob Filho

ABSTRACT Objectives: To assess the effect of exercise on gait using two different programs: a group of aerobic exercises (Group A, n = 18) and a group of flexibility and balance exercises (Group B, n = 19). Methods: A casualized controlled study, in which each sample controlled itself, was undertaken. The sample comprised 37 male and female subjects, aged from 60 to 90 years, from the outpatient clinic of the Geriatrics Unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo; the patients were sedentary and had not exercised regularly during the past six months. Results: Improvement of gait was seen mainly in the group that did specific exercises. Conclusion: The results of this study underline the importance of physical exercises in sedentary elderly subjects, but show the need for programming the exercises towards specific goals, which can optimize the results of this tool of health promotion for the elderly.


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