Comparison of adjustable sutures versus nonadjustable sutures in intermittent exotropia

2017 ◽  
Vol 28 (3) ◽  
pp. 264-267 ◽  
Author(s):  
Kamlesh ◽  
Suresh Babu ◽  
Yashpal Goel ◽  
Rupak Brahma Chaudhary ◽  
Anju Rastogi ◽  
...  

Purpose: To compare adjustable sutures versus nonadjustable sutures for intermittent exotropia. Methods: In this randomized prospective interventional study, 40 adult patients with intermittent exotropia were randomly divided into 2 equal groups. Both groups underwent bilateral lateral rectus recession. In group A, adjustable suture recession was performed, and in group B, nonadjustable suture recession was performed. Patients were followed up for 6 months and outcome measures were residual deviation, binocular status, and need for resurgery. Results: Success was defined as alignment of 2 eyes <10 prism diopters (PD) of deviation at the end of 12 weeks. Need for resurgery in a 12-week follow-up period was considered to be failure. At the end of the study, 90% of the patients in group A and 85% of the patients were within 10 prism diopters of orthophoria (p = 0.316). At the end of 6 months, mean deviation in group A was 6.20 PD and in group B it was 5.60 PD (p = 0.31). No patient underwent resurgery. Conclusions: Adjustable hang-back recession has no definite added advantage over nonadjustable hang-back recession in intermittent exotropia.

Author(s):  
Sakib Arfee ◽  
Asma Jabeen ◽  
Akib Arfee ◽  
Adnan Aadil Arfee

Background: Almost four centuries back fracture neck of femur was described, but till today this fracture is unsolved, though situation has largely improved from the days of Sir Astley Cooper, who had said “I have never met one in whom union had taken place”. High incidence of complications with this fracture even in modern day show that we still have not found way to treat this fracture appropriately and its treatment remains a challenging problem. The objective of the study was to assess the final outcome of management of intracapsular fracture neck of femur in young adult patients after internal fixation.Methods: This study has been conducted at Orthopedic Department of Government Medical College and hospital, Jammu from 2018 to 2020. 30 young adult patients with fractures neck of femur treated with CCS (27 patients) and DHS (3 patients) after taking informed consent were selected for the study.Results: 30 young adult patients in age group of 18-60 years, constituted this study. 27 patients were treated with closed reduction and internal fixation with CCS (group A) and 3 patients were treated with DHS (group B). 3 patients were lost to the follow up, all of them from group A.Conclusions: DHS appears to be more forgiving implant than CCS in fracture neck of femur in young adult patients. However number in this group is very small and hence larger studies are needed. In fixation with CCS anatomical reduction of fracture, proper screw placement is the most important criterion for achieving better results.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shuying Dai ◽  
Weifeng Sun ◽  
Hongjia Xu ◽  
Yanan Wang ◽  
Yuan Liu ◽  
...  

Objective. To explore the effect of applying binocular visual training after slanted lateral rectus recession on orthophoric rate and binocular visual function recovery on patients with convergence insufficiency-type intermittent exotropia (CI-IXT). Methods. A total of 76 CI-IXT child patients treated at the Strabismus and Pediatric Ophthalmology Department of our hospital from June 2019 to June 2020 were selected as the research objects, and those who met the inclusion criteria were equally divided into group A (63 eyes) and group B (61 eyes) according to the sealed envelope randomization. All child patients accepted the slanted lateral rectus recession, and after that, those in group A accepted the binocular visual training and those in group B accepted the conventional visual function rehabilitation training, so as to compare their position of eye, the best corrected visual acuity, etc., after training for statistical analysis. Results. Compared with group B after one month of surgery, group A had significantly less patients with grade I binocular vision function ( P  < 0.001) and more patients with grade II and III vision function ( P  < 0.05); between group A and group B, after 3 months and 6 months of treatment, the number of eyes with normal stereoscopic vision was significantly higher in group A ( P  < 0.05); at 15 days, 1 month, 3 months, and 6 months of treatment, the visual strain scores of group A were significantly lower ( P  < 0.001); after treatment, the number of orthophoria eyes was significantly higher in group A ( P  < 0.001), while the numbers of overcorrected eyes and undercorrected eyes were significantly higher in group B ( P  < 0.001); and the total incidence rate of adverse reactions was significantly lower in group A ( P  < 0.05). Conclusion. Applying binocular visual training to child patients with CI-IXT after slanted lateral rectus recession can promote the recovery of binocular vision and ensure higher safety, and further study will help to establish a better solution for the affected children.


2020 ◽  
Vol 27 (04) ◽  
pp. 796-806
Author(s):  
Tafazzul Hussain ◽  
Mohsin Turab ◽  
Musarrat Sultana ◽  
Fuad Shaikh ◽  
Syed Saud Hasan ◽  
...  

Objectives: To assess the improvement, safety and tolerability of Allopurinol 300mg/daily & Febuxostat 80mg/daily in hyperuricemic patients. Study Design: Clinical Interventional Study. Setting: Medical OPD, Dr. Ruth K M Pfau Civil Hospital Karachi. Period: From September 2018 to March 2019. Material & Methods: The designed interventional study from the Department of Pharmacology Hamdard College of Medicine & Dentistry, approved by BASR & Ethical Review Board of Hamdard University Karachi. Initially 70 enrolled patients, 60-patients of sUA>6.8 mg/dl were registered, after fulfilled the inclusion and exclusion criteria and written consent, detail history on pro forma and biochemical assessments (sUA, S. Creatinine, Alkaline Phosphate, SGPT, Cholesterol, HDL, LDL and Blood sugar were measured at day 0), repeated at day 30, 60 and 90, keep in case record file, on follow up visits for final analysis. Group A, (Allopurinol) & B (Febuxostat) results data were compared of sUA, S. Creatinine and biochemical assessments, to estimate the improvement, safety and tolerability of the drugs. Results: Group-A baseline uric acid were, mean 8.79 ± 0.98 to mean 6.40 ± 0.86 with percentage change was 26%. Group-B treated sUA were changed mean 8.85±0.97 to 5.96±0.68 with percentage change was 33%. Overall improvement in mean was statistically highly significant. Mean difference ± SD for change of serum uric acid in Group-A is 2.39±1.15 with Group-B mean change is 2.90±0.87. Drug safety was determined by adverse effects and blood assay of follow up at day-90 from baseline. Conclusion: Improvement reported by mean of reduced uric acid & no serious adverse effects, results are highly significant.


Author(s):  
Vangala Chandrasekhara Reddy ◽  
Sagili Chandrasekhara Reddy

Purpose: To evaluate and compare the effectiveness of lateral rectus muscle recession with Y-splitting versus recession only in the surgical treatment of up/down shoot in Duane retraction syndrome patients. Material and Methods: In this prospective study, 42 patients of Duane retraction syndrome with up/down shoot underwent surgery over a period of seven years, were divided into two groups of twenty one each.  In group A, Y-splitting of lateral rectus with recession and in group B, only lateral rectus recession was performed. In all the patients width of lateral rectus muscle at its insertion was measured. Postoperative results were compared and analyzed in terms of up/down shoot on adduction. Data analysis was performed using R Core Team (2020) R., and the P value <0.05 was taken as significant. Results: The Mean age at the time of surgery was 12.5 ± 4.5 years in group A, and 11.5 ± 3.9 years in group B (range, 5 to 22 years). Correction of up/down shoot was 100% in group A and 81% in group B. Five patients in group B showed no improvement of up/down shoot in whom the width of lateral rectus was 7mm or less and the surgery was recession of lateral rectus only. In these 5 patients, Y-splitting of lateral rectus was done in second sitting with good result Mean follow up was 12 months (range, 3 weeks to 3 years). Conclusions: Recession of lateral rectus muscle with Y-splitting is  more effective (100%) when compared to recession only, in correcting significant up/down shoot in Duane retraction syndrome. Lateral rectus muscle Y- splitting is not necessary in these patients with upshoot / down shoot if the width of the muscle at insertion is within normal limits (8.3 -12.5 mm). In these cases simple recession is enough. Lateral rectus muscle Y splitting is essential when the width of lateral rectus muscle at insertion is 7mm or less.


VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.


2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.


Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.


Author(s):  
Renuka M. Tenahalli

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.


2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43


2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110222
Author(s):  
Ling Mo ◽  
Zixian Wu ◽  
De Liang ◽  
Linqiang Y ◽  
Zhuoyan Cai ◽  
...  

Objective To evaluate the influence of insufficient bone cement distribution on outcomes following percutaneous vertebroplasty (PVP). Methods This retrospective matched-cohort study included patients 50–90 years of age who had undergone PVP for single level vertebral compression fractures (VCFs) from February 2015 to December 2018. Insufficient (Group A)/sufficient (Group B) distribution of bone cement in the fracture area was assessed from pre- and post-operative computed tomography (CT) images. Assessments were before, 3-days post-procedure, and at the last follow-up visit (≥12 months). Result Of the 270 eligible patients, there were 54 matched pairs. On post-operative day 3 and at the last follow-up visit, significantly greater visual analogue scale (VAS) pain scores and Oswestry Disability Index (ODI) scores were obtained in Group B over Group A, while kyphotic angles (KAs) and vertebral height (VH) loss were significantly larger in Group A compared with Group B. Incidence of asymptomatic cement leakage and re-collapse of cemented vertebrae were also greater in Group A compared with Group B. Conclusions Insufficient cement distribution may relate to less pain relief and result in progressive vertebral collapse and kyphotic deformity post-PVP.


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