scholarly journals The Profile of Pharmacological Treatment in Trigeminal Neuralgia Patients in The Period of January 2018-December 2018

2020 ◽  
Vol 4 (9) ◽  
pp. 301-305
Author(s):  
Marlon Yutimma Roestam Moenaf ◽  
Maftuchah Rochmanti ◽  
Devi Ariani Sudibyo
Keyword(s):  
Trigeminal Neuralgia ◽  
Gold Standard ◽  
Standard Treatment ◽  
Treatment Guideline ◽  
Pain Scale ◽  
The Third ◽  
Significant Pain ◽  
Keywords Trigeminal Neuralgia ◽  
Almost All ◽  
Scale Data

Trigeminal neuralgia is a condition that affects the trigeminal nerve, that manifests in a series of stabbing like pain, and often described like electricity. Its treatment guideline is to prioritize pharmacotherapy until patient is well. The gold standard treatment for trigeminal neuralgia is pharmacotherapy of Carbamazepine. However, carbamazepine is proven to cause allergic reaction to some patients. This research aims to describe the pharmacotherapy that is given to patients. The regiments of pharmacotherapy in trigeminal neuralgia shows that CBZ is the main pharmacotherapy given, as it is the gold standard treatment. GBP is the is the second most pharmacotherapy given and a concoction medication of Paracetamol, Diazepam and Amitriptyline being the third most favored therapy. Neurotropic B Vitamins plays a big role, as a support in the therapy to maintain the health of the overall nervous system. The pain scale data shows that almost all patients have significant pain relieve. The therapy of trigeminal neuralgia in this study shows that CBZ is most favored as it is the gold standard, however not all AEDs are accessible. Almost all patients have significant pain relieve eventhough not using gold standard treatment. Keywords: trigeminal neuralgia; pharmacotherapy

The Silent Sinus Syndrome: A Clinical Review

2010 ◽  
Vol 3 (2) ◽  
pp. 69-72
Author(s):  
Natasha Choudhury ◽  
Joe Marais
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Younger Patients ◽  
The Third ◽  
Silent Sinus Syndrome ◽  
Orbital Floor Reconstruction ◽  
Negative Pressures ◽  
Sinonasal Disease

Abstract Silent sinus syndrome (SSS) is a rare and interesting clinical condition that is associated with spontaneous, painless, unilateral enophthalmos and hypoglobus resulting from downward bowing of the orbital floor, in the absence of any symptomatic sinonasal disease. It generally affects younger patients between the third and fifth decades of life. The pathogenesis of silent sinus syndrome is based on chronic maxillary sinus obstruction, related to occlusion of the maxillary infundibulum which results in a hypoventilated sinus and negative pressures. Endoscopic sinus surgery to create a wide maxillary antrostomy with or without orbital floor reconstruction is considered the gold standard treatment of choice.

Changes in the muscles of mastication before and after primary stereotactic radiosurgery in patients with idiopathic trigeminal neuralgia

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Nasser Mohammed ◽  
Yi-Chieh Hung ◽  
Thomas J. Eluvathingal Muttikkal ◽  
Roy C. Bliley ◽  
Zhiyuan Xu ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Muscle Atrophy ◽  
Motor Neuropathy ◽  
Significant Pain ◽  
Medial Pterygoid ◽  
Before And After ◽  
Pterygoid Muscles ◽  
Masseter Muscles ◽  
Muscles Of Mastication ◽  
New Onset

OBJECTIVEThe motor root of the trigeminal nerve runs close to the sensory root and receives considerable radiation during Gamma Knife radiosurgery (GKRS) for trigeminal neuralgia (TN). The object of this study was to evaluate via MRI the changes in the muscles of mastication before and after upfront GKRS in patients with idiopathic TN.METHODSIn this single-institution retrospective cohort study, all patients with idiopathic unilateral TN treated with primary GKRS at the University of Virginia in the period from 2007 to 2017 were included provided that they had pre- and post-GKRS MRI data. The thicknesses of the temporalis, pterygoid, and masseter muscles were measured on both pre- and post-GKRS MRI in a blinded fashion. Changes in the muscles like fatty infiltration, MRI signal, or atrophy were noted.RESULTSAmong the 68 patients eligible for inclusion in the study, 136 temporalis muscles, 136 medial pterygoid muscles, 136 lateral pterygoid muscles, and 136 masseter muscles were assessed. A subset of patients was found to have muscle atrophy even prior to GKRS. Pre-GKRS atrophy of the masseter, medial pterygoid, lateral pterygoid, and temporalis muscles was seen in 18 (26%), 16 (24%), 9 (13%), and 16 (24%) patients, respectively. Logistic regression analysis showed that distribution of pain in the V3 territory (p = 0.01, OR 5.43, 95% CI 1.46–20.12) and significant pain on chewing (p = 0.02, OR 5.32, 95% CI 1.25–22.48) were predictive of pre-GKRS atrophy. Reversal of atrophy of these muscles occurred after GKRS in a majority of the patients. The incidence of new-onset permanent post-GKRS muscle atrophy was 1.5%. The median follow-up was 39 months (range 6–108 months).CONCLUSIONSA subset of patients with TN with significant pain on chewing have pre-GKRS disuse atrophy of the muscles of mastication. A reversal of the atrophy occurs in a majority of the patients following GKRS. New-onset motor neuropathy post-GKRS was rare.

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Delayed unilateral pneumocephalus after bilateral endoscopic dacryocystorhinostomy in an elderly patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241540
Author(s):  
Jaekyoung Lee ◽  
Dong Cheol Lee
Keyword(s):  
Elderly Patient ◽  
Cerebrospinal Fluid ◽  
Gold Standard ◽  
Standard Treatment ◽  
Nasolacrimal Duct ◽  
Intravenous Antibiotic ◽  
Duct Obstruction ◽  
Orbital Wall ◽  
Silicone Intubation ◽  
Endoscopic Dcr

Dacryocystorhinostomy (DCR) is the ‘gold standard’ treatment for nasolacrimal duct obstruction (NLDO). However, despite its recent technical advancements, complications are possible. Herein, to the best of our knowledge, we present the first reported case of delayed unilateral pneumocephalus after bilateral endoscopic DCR. An 85-year-old man with bilateral NLDO underwent endoscopic DCR with silicone intubation. After 1 month, he became lethargic and was admitted to emergency room. Brain CT demonstrated left pneumocephalus and a suspected microfistula in left orbital wall. Intravenous antibiotic therapy was started, and cerebrospinal fluid studies showed no evidence of meningitis. After 13 days of antibiotic treatment, his mental state recovered with no signs of pneumocephalus. Although DCR has high success rate and is relatively safe, surgeons should be aware of the risk, although low, of pneumocephalus, especially in elderly patients who are vulnerable to fractures and who exhibit headache or mental status changes after endoscopic DCR.

scholarly journals Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

2021 ◽  
Vol 28 (4) ◽  
pp. 2317-2325
Author(s):  
Luigi Bennardo ◽  
Francesco Bennardo ◽  
Amerigo Giudice ◽  
Maria Passante ◽  
Stefano Dastoli ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gold Standard ◽  
Systemic Chemotherapy ◽  
Standard Treatment ◽  
Case Reports ◽  
Case Series ◽  
Surgical Removal ◽  
Local Chemotherapy

Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

Treatment of vertigo and postural instability using visual illusions

2014 ◽  
Vol 128 (11) ◽  
pp. 1005-1007 ◽  
Author(s):  
G van Kerckhoven ◽  
A Mert ◽  
J A De Ru
Keyword(s):  
Gold Standard ◽  
Prosthetic Valve ◽  
Standard Treatment ◽  
Vestibular Function ◽  
Prosthetic Valve Endocarditis ◽  
Postural Instability ◽  
Risk Of Falling ◽  
Important Advance ◽  
Dizziness Handicap Inventory ◽  
Increased Risk

AbstractBackground:Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current ‘gold standard’ treatment available.Case report:A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function.Results:The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score.Conclusion:Computer-aided rehabilitation programmes might represent an important advance in gait and posture training.

ROOT END FILLING MATERIALS – A REVIEW

2021 ◽  
pp. 5-9
Author(s):  
Bynagari Chandra Shekar ◽  
Veerendra Uppin ◽  
Madhu Pujar
Keyword(s):  
Root Canal ◽  
Gold Standard ◽  
The Past ◽  
Filling Materials ◽  
Restorative Materials ◽  
The Creation ◽  
Almost All

The aim of a root end lling is to prevent irritants from the root canal from leaking into the periapical region and to improve the apical seal created by nonsurgical endodontic care. Various restorative materials that have been used for coronal restorations have been tried and tested as root end lling materials, as well as the creation of restorative materials designed specically for root end lling. In the past, amalgam was the preferred material for root end lling. MTA, a recently established material that meets almost all of the criteria for an ideal root end lling material, has become the gold standard against which newer materials are measured. This article examines traditional endodontic root end materials and provides an overview of recent advancements in root end lling

scholarly journals THE LOCATION OF THE XANTHATE GROUPS IN PARTLY SUBSTITUTED CELLULOSE XANTHATES

1957 ◽  
Vol 35 (12) ◽  
pp. 1522-1533 ◽  
Author(s):  
E. P. Swan ◽  
C. B. Purves
Keyword(s):  
Cellulose Acetate ◽  
Chlorine Dioxide ◽  
Methyl Esters ◽  
Lead Tetraacetate ◽  
Degree Of Substitution ◽  
Hydroxyl Groups ◽  
Primary Position ◽  
Standard Methods ◽  
The Third ◽  
Almost All

Cellulose sodium xanthates of degree of substitution (D.S.) 0.4 to 0.66 were methylated to xanthate S-methyl esters which were then acetylated completely, the final xanthate D.S. remaining close to the original value. Dexanthation with aqueous chlorine dioxide near pH 4.5 and −5° removed almost all of the S-methyl xanthate groups, but the loss of a few acetyl groups from, and the retention of 1 to 2% of sulphur in, the resulting cellulose acetate could not be avoided. The original xanthate groups were presumably represented in this acetate as unsubstituted hydroxyl groups, and these were located by standard methods involving tosylation–iodination, tritylation, and oxidations with lead tetraacetate. Xanthate groups appeared to occupy the third and sixth, but not the second, position in the cellulose, and 53 to 61% of the substituent was in the sixth or primary position; one sample of viscose was "ripened" before the cellulose sodium xanthate was isolated, and the value was 81%. The results were of a preliminary nature, because severe technical difficulties reduced their reliability.

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