Nilesh S. Sakharkar, P. Tathe, Prateek Jain, Aniket N. Adewar, Santosh Pol
Abstract Background Plantar fasciitis is the most common cause of heel pain and is difficult to treat in most chronic and severe forms. Management of plantar fasciitis includes non-surgical options such as non-steroidal anti-inflammatory drugs and corticosteroids, physical therapy, orthotics, and surgical management includes plantar fasciotomy. Local injection of platelet-rich plasma as well as local steroids is an emerging concept in treating recalcitrant tendon and ligament pathology, including plantar fasciitis. Objectives The aim of the study was to evaluate and compare the outcome of patients treated with a single injection of autologous leucocyte-rich platelet-rich plasma with single-injection local steroids triamcinolone in chronic plantar fasciitis. Methodology The study was conducted for a duration of 24 months. In total, 60 patients with clinically diagnosed chronic plantar fasciitis were selected for study and divided in two groups using the single allocation randomization method as those treated with autologous injection leucocyte-rich platelet-rich plasma and those with injection local steroid triamcinolone and prospectively followed and compared. Results Both groups were evaluated subjectively and functionally at primary visit and then on follow-up at 2 weeks, 4 weeks, 8 weeks, and 12 weeks by VAS and hind foot AOFAS score. Conclusion We concluded that both injection platelet-rich plasma-treated and injection local steroid-treated patients provide symptomatic relief in the treatment of chronic plantar fasciitis both subjectively and functionally. The steroid treated group showed early symptomatic improvement at 2 weeks, and results at 12 weeks to further follow-up were suggestive that single-injection leucocyte-rich platelet-rich plasma provided better functional results.
{"title":"Prospective Comparative Short-Term Study of Autologous Leucocyte-Rich Platelet-Rich Plasma vs. Local Steroids in Chronic Plantar Fascitis","authors":"Nilesh S. Sakharkar, P. Tathe, Prateek Jain, Aniket N. Adewar, Santosh Pol","doi":"10.1055/s-0043-1761456","DOIUrl":"https://doi.org/10.1055/s-0043-1761456","url":null,"abstract":"Abstract Background Plantar fasciitis is the most common cause of heel pain and is difficult to treat in most chronic and severe forms. Management of plantar fasciitis includes non-surgical options such as non-steroidal anti-inflammatory drugs and corticosteroids, physical therapy, orthotics, and surgical management includes plantar fasciotomy. Local injection of platelet-rich plasma as well as local steroids is an emerging concept in treating recalcitrant tendon and ligament pathology, including plantar fasciitis. Objectives The aim of the study was to evaluate and compare the outcome of patients treated with a single injection of autologous leucocyte-rich platelet-rich plasma with single-injection local steroids triamcinolone in chronic plantar fasciitis. Methodology The study was conducted for a duration of 24 months. In total, 60 patients with clinically diagnosed chronic plantar fasciitis were selected for study and divided in two groups using the single allocation randomization method as those treated with autologous injection leucocyte-rich platelet-rich plasma and those with injection local steroid triamcinolone and prospectively followed and compared. Results Both groups were evaluated subjectively and functionally at primary visit and then on follow-up at 2 weeks, 4 weeks, 8 weeks, and 12 weeks by VAS and hind foot AOFAS score. Conclusion We concluded that both injection platelet-rich plasma-treated and injection local steroid-treated patients provide symptomatic relief in the treatment of chronic plantar fasciitis both subjectively and functionally. The steroid treated group showed early symptomatic improvement at 2 weeks, and results at 12 weeks to further follow-up were suggestive that single-injection leucocyte-rich platelet-rich plasma provided better functional results.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86795386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meckel ’ s diverticulum isfound in2% of the population, which makes it the commonest congenital abnormality of the gastrointestinal tract. It is diagnosed as an incidental fi nding during surgery for other reasons. It is found 100cm from the ileocecal junction, at the antimesenteric border. Other pre-sentations can be abdominal pain, infection, bleeding from ectopic mucosa, recurrent intestinal obstruction
{"title":"Incidentally Detected Meckel Diverticulum during Cystectomy: An Unhinging Dilemma?","authors":"Manjeet Kumar","doi":"10.1055/s-0043-1761468","DOIUrl":"https://doi.org/10.1055/s-0043-1761468","url":null,"abstract":"Meckel ’ s diverticulum isfound in2% of the population, which makes it the commonest congenital abnormality of the gastrointestinal tract. It is diagnosed as an incidental fi nding during surgery for other reasons. It is found 100cm from the ileocecal junction, at the antimesenteric border. Other pre-sentations can be abdominal pain, infection, bleeding from ectopic mucosa, recurrent intestinal obstruction","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79941712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The therapeutic approach to immune-mediated diseases including Crohn's disease has dramatically improved with the introduction of immunomodulators such as anti-tumor necrosis factor (TNF). However, its use is not complication-free, and since its introduction, a growing number of opportunistic infections is being reported in patients under treatment despite all preventive measures taken. Herein, we report a case of adalimumab-induced isolated peritoneal tuberculosis.
{"title":"Adalimumab-Induced Isolated Peritoneal Tuberculosis","authors":"M. Saad, F. Ghandour, E. Saikaly","doi":"10.1055/s-0043-1761477","DOIUrl":"https://doi.org/10.1055/s-0043-1761477","url":null,"abstract":"Abstract The therapeutic approach to immune-mediated diseases including Crohn's disease has dramatically improved with the introduction of immunomodulators such as anti-tumor necrosis factor (TNF). However, its use is not complication-free, and since its introduction, a growing number of opportunistic infections is being reported in patients under treatment despite all preventive measures taken. Herein, we report a case of adalimumab-induced isolated peritoneal tuberculosis.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84634466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abhay Saini, Navneet Mishra, Priya Kushwah, Mohammad Toseef, Tanweerul Huda
Abstract Background The history of hernia repair is the history of the surgery itself. The surgical management of inguinal hernia has continuously evolved for 200 years. Aim This article determines the incidence of recurrence, chronic pain, and complications following open, tension-free Lichtenstein hernioplasty using a minimal stitch approach. Material and Methods This was a single-center, hospital-based, prospective observational study. A total of 197 participants with uncomplicated hernias were enrolled. All participants were operated following open, tension-free, minimal stitch Lichtenstein hernioplasty. The duration of follow-up was 6 months. Results Thirty-one (15.7%) participants were lost to follow-up, and 154 (78.2%) participants completed the follow-up. Making total of 166 cases (of which 142 were unilateral and 12 were bilateral, counted as 24 individually). Overall, right-sided direct inguinal hernia (30%) was the most common type, followed by right-sided indirect hernia (26%). Most participants (85%) were given three sutures to fix the mesh during open tension-free hernioplasty. The incidence of postoperative complications, including wound infection, hematoma, and seroma, was zero among participants in each group. The incidence of chronic pain and recurrence at 3 and 6 months after the surgery was zero among all participants. Conclusion Most patients in this study required three stitches to fix the mesh during hernioplasty. There were zero incidences of chronic pain, recurrence of the hernia, or any postoperative complication among participants. Thus, hernioplasty can be safely and effectively performed with minimal sutures among male patients with either unilateral or bilateral uncomplicated hernia.
{"title":"An Observational Analysis of Mesh Fixation with Minimum Sutures and Its Postoperative Outcomes","authors":"Abhay Saini, Navneet Mishra, Priya Kushwah, Mohammad Toseef, Tanweerul Huda","doi":"10.1055/s-0043-1761617","DOIUrl":"https://doi.org/10.1055/s-0043-1761617","url":null,"abstract":"Abstract Background The history of hernia repair is the history of the surgery itself. The surgical management of inguinal hernia has continuously evolved for 200 years. Aim This article determines the incidence of recurrence, chronic pain, and complications following open, tension-free Lichtenstein hernioplasty using a minimal stitch approach. Material and Methods This was a single-center, hospital-based, prospective observational study. A total of 197 participants with uncomplicated hernias were enrolled. All participants were operated following open, tension-free, minimal stitch Lichtenstein hernioplasty. The duration of follow-up was 6 months. Results Thirty-one (15.7%) participants were lost to follow-up, and 154 (78.2%) participants completed the follow-up. Making total of 166 cases (of which 142 were unilateral and 12 were bilateral, counted as 24 individually). Overall, right-sided direct inguinal hernia (30%) was the most common type, followed by right-sided indirect hernia (26%). Most participants (85%) were given three sutures to fix the mesh during open tension-free hernioplasty. The incidence of postoperative complications, including wound infection, hematoma, and seroma, was zero among participants in each group. The incidence of chronic pain and recurrence at 3 and 6 months after the surgery was zero among all participants. Conclusion Most patients in this study required three stitches to fix the mesh during hernioplasty. There were zero incidences of chronic pain, recurrence of the hernia, or any postoperative complication among participants. Thus, hernioplasty can be safely and effectively performed with minimal sutures among male patients with either unilateral or bilateral uncomplicated hernia.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78845426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Singhal, P. Nayak, V. Padiyar, Kanwar Sen, S. Shrivastava
Abstract Background Deep neck space infections (DNIs) are a major medical concern in the Indian community. Owing to the complex anatomy of the neck spaces and their communication with each other, accurate diagnosis becomes challenging. A thorough knowledge of the anatomy as well as the microbiological profile and antibiotic sensitivity is imperative to institute the appropriate surgical and medical management to the patient. Due to the advent of broad-spectrum antibiotics, the incidence of these infections have declined considerably over the last couple of decades. However, due to the extensive and unregulated use, the incidence of antibiotic resistance has also been increasing at an alarming pace. Materials and Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology at a tertiary care government hospital in an urban area. All patients who presented to the OPD or emergency over a period of 18 months and who fulfilled the eligibility criteria were included in the study. Pus was collected from the abscess, aseptically by needle aspiration using wide bore (18G) needle and transported under all aseptic measures within 24 hours for culture and sensitivity, KOH mount, and detection of AFB. Antibiotic sensitivity testing was done using the Kirby Bauer disc diffusion method and E-test. Results Staphylococcus aureus as the most common infective organism followed by MRSA in the pediatric age group and Klebsiella pneumoniae in adults. Conclusion Primary knowledge of individual antibiotic sensitivity is imperative to ensure prompt and adequate treatment of the patient with higher chances of complete resolution, concomitantly minimizing the risk of resistance. Inadequate and delayed treatment may lead to swift progression of the disease with significant morbidity and mortality.
{"title":"Evaluation of Antibiotic Sensitivity in Deep Neck Space Infections","authors":"G. Singhal, P. Nayak, V. Padiyar, Kanwar Sen, S. Shrivastava","doi":"10.1055/s-0043-1761508","DOIUrl":"https://doi.org/10.1055/s-0043-1761508","url":null,"abstract":"Abstract Background Deep neck space infections (DNIs) are a major medical concern in the Indian community. Owing to the complex anatomy of the neck spaces and their communication with each other, accurate diagnosis becomes challenging. A thorough knowledge of the anatomy as well as the microbiological profile and antibiotic sensitivity is imperative to institute the appropriate surgical and medical management to the patient. Due to the advent of broad-spectrum antibiotics, the incidence of these infections have declined considerably over the last couple of decades. However, due to the extensive and unregulated use, the incidence of antibiotic resistance has also been increasing at an alarming pace. Materials and Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology at a tertiary care government hospital in an urban area. All patients who presented to the OPD or emergency over a period of 18 months and who fulfilled the eligibility criteria were included in the study. Pus was collected from the abscess, aseptically by needle aspiration using wide bore (18G) needle and transported under all aseptic measures within 24 hours for culture and sensitivity, KOH mount, and detection of AFB. Antibiotic sensitivity testing was done using the Kirby Bauer disc diffusion method and E-test. Results Staphylococcus aureus as the most common infective organism followed by MRSA in the pediatric age group and Klebsiella pneumoniae in adults. Conclusion Primary knowledge of individual antibiotic sensitivity is imperative to ensure prompt and adequate treatment of the patient with higher chances of complete resolution, concomitantly minimizing the risk of resistance. Inadequate and delayed treatment may lead to swift progression of the disease with significant morbidity and mortality.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83545268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Narendra S. Mashalkar, Naren Shetty, Sunderraj Ellur
Abstract Aims To analyze the etiology, anatomical pattern, and management of upper, midface, and lower face fractures pertaining to our demography and compare our results with other regions and worldwide. Materials and methods A 6-year retrospective record analysis from 2013 to 2018 of eligible patients' data was recorded with a prepared proforma. Demographic parameters including age, sex, etiology, anatomical site, closed or open, displaced or un displaced fracture, type of treatment, associated with head injury, and implants used were evaluated. Inclusion criteria were all patients with facial bone fractures irrespective of age and gender. Exclusion criteria were patients with pure soft tissue injury of the face and with facial burns. Results Most were involved with multiple facial bone fractures. Out of 196, 72 patients (pts) had involvement of mandible fractures, 79 had involvement of the maxilla, 65 zygoma, 68 nasal bone, 42 orbital wall, 21 frontal bone with processes, and 7 NOE involvement. The most frequent etiologic factor was detected to be road traffic accidents (RTA; 162 ,83%), due to falling (24, 12%), and assault (10, 5%). In total, 173 were male (88%) and the rest 23 were female (12%). The mean age was found to be 29 years. Twelve patients (6.1%) were less than 14 years of age. Most RTAs had occurred in young adults from 16 to 30 years of age group. We analyzed individual bone fracture involvement and compared it with other geographical locations. Conclusions Most facial fractures are combined involving multiple bones in young adults with RTA as the most common etiology. There was a balance seen in managing the facial fractures between conservative and operative methods. These data provide us the information in evaluation of the preventive measures to be taken and give the direction of focusing the clinical and research priority in the future.
{"title":"Descriptive and Surgical Analysis of 196 Cases of Traumatic Maxillofacial Fractures: An experience of 6 years","authors":"Narendra S. Mashalkar, Naren Shetty, Sunderraj Ellur","doi":"10.1055/s-0043-1761506","DOIUrl":"https://doi.org/10.1055/s-0043-1761506","url":null,"abstract":"Abstract Aims To analyze the etiology, anatomical pattern, and management of upper, midface, and lower face fractures pertaining to our demography and compare our results with other regions and worldwide. Materials and methods A 6-year retrospective record analysis from 2013 to 2018 of eligible patients' data was recorded with a prepared proforma. Demographic parameters including age, sex, etiology, anatomical site, closed or open, displaced or un displaced fracture, type of treatment, associated with head injury, and implants used were evaluated. Inclusion criteria were all patients with facial bone fractures irrespective of age and gender. Exclusion criteria were patients with pure soft tissue injury of the face and with facial burns. Results Most were involved with multiple facial bone fractures. Out of 196, 72 patients (pts) had involvement of mandible fractures, 79 had involvement of the maxilla, 65 zygoma, 68 nasal bone, 42 orbital wall, 21 frontal bone with processes, and 7 NOE involvement. The most frequent etiologic factor was detected to be road traffic accidents (RTA; 162 ,83%), due to falling (24, 12%), and assault (10, 5%). In total, 173 were male (88%) and the rest 23 were female (12%). The mean age was found to be 29 years. Twelve patients (6.1%) were less than 14 years of age. Most RTAs had occurred in young adults from 16 to 30 years of age group. We analyzed individual bone fracture involvement and compared it with other geographical locations. Conclusions Most facial fractures are combined involving multiple bones in young adults with RTA as the most common etiology. There was a balance seen in managing the facial fractures between conservative and operative methods. These data provide us the information in evaluation of the preventive measures to be taken and give the direction of focusing the clinical and research priority in the future.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85732881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eva Sherin Saravana Kumar, S. A. Singh, Bala Vidhya Sagar, Nithila Chithambaram, S. Jeyasekharan, D. Jeyasekharan
Abstract Introduction Abdominal compartment syndrome is a life-threatening condition that affects critically ill patients. When pressures inside a fixed cavity of the body increases, ischemia, muscle injury, and organ failure can result. Aim To assess the benefits and outcomes of laparostomy for abdominal compartment syndrome. Methods This retrospective study included patients who underwent a laparostomy procedure as a treatment measure for abdominal compartment syndrome, secondary to different etiologies such as sepsis and major abdominal visceral trauma. Results Although there are a few complications such as incisional hernia in the future following a laparostomy, the mortality rate following the procedure is less than < 10%, thus ensuring a good prognosis for patients who present with acute surgical emergencies. It could also be further noted that an early closure by 7 to 14 days had definite beneficial outcomes as compared with delayed closure of more than 14 days. It prevented most long-term complications such as entero-atmospheric fistula formation or granuloma formation, the outcomes of which were further aided by the use of a transparent custom-made polypropylene mesh. Conclusion Laparostomy is the gold standard treatment for abdominal compartment syndrome. The use of a custom-made polypropylene mesh has proven to have the least complications in the follow-up period. Incisional hernias are the most common complications documented, followed by entero-atmospheric fistula.
{"title":"Outcome of Laparostomy as a Treatment Measure for Abdominal Compartment Syndrome: A Retrospective Study","authors":"Eva Sherin Saravana Kumar, S. A. Singh, Bala Vidhya Sagar, Nithila Chithambaram, S. Jeyasekharan, D. Jeyasekharan","doi":"10.1055/s-0043-1761457","DOIUrl":"https://doi.org/10.1055/s-0043-1761457","url":null,"abstract":"Abstract Introduction Abdominal compartment syndrome is a life-threatening condition that affects critically ill patients. When pressures inside a fixed cavity of the body increases, ischemia, muscle injury, and organ failure can result. Aim To assess the benefits and outcomes of laparostomy for abdominal compartment syndrome. Methods This retrospective study included patients who underwent a laparostomy procedure as a treatment measure for abdominal compartment syndrome, secondary to different etiologies such as sepsis and major abdominal visceral trauma. Results Although there are a few complications such as incisional hernia in the future following a laparostomy, the mortality rate following the procedure is less than < 10%, thus ensuring a good prognosis for patients who present with acute surgical emergencies. It could also be further noted that an early closure by 7 to 14 days had definite beneficial outcomes as compared with delayed closure of more than 14 days. It prevented most long-term complications such as entero-atmospheric fistula formation or granuloma formation, the outcomes of which were further aided by the use of a transparent custom-made polypropylene mesh. Conclusion Laparostomy is the gold standard treatment for abdominal compartment syndrome. The use of a custom-made polypropylene mesh has proven to have the least complications in the follow-up period. Incisional hernias are the most common complications documented, followed by entero-atmospheric fistula.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89212607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-29DOI: 10.32457//ijmss.v10i1.2087
A. Benítez, S. Toso, C. Mena, E. Pérez
Chronic rhinosinusitis (CRS) is a chronic condition of inflammation in the mucosa of the paranasal sinuses that is associated with a significantly impaired quality of life, which motivates the constant study of therapies for its control and cost reduction. The cutting edge of clinical management for CRS is topical therapy. The advantages of topical medical therapy include direct administration of the drug into the diseased tissue, the possibility of administering higher local concentrations of the drug and minimizing systemic absorption which is not without adverse effects, thus becoming an important strategy in the management of CRS. The objective of this literature review is to formally review and identify topical medical therapy strategies and promote an evidence-based approach to their use. A literature review was conducted based on a keyword search. The computerized databases of PubMed, ElSevier and ResearchGate were accessed. We included articles highlighting the results of the use of topical therapies in CRS and that the type of study was a clinical trial. This review identified and evaluated the literature on topical therapy strategies for CRS: saline irrigation, topical antibiotics, topical steroids, and topical antifungals. Topical therapy has become an important tool in the treatment arsenal for CRS. Based on a review of the literature, nasal irrigation with saline and topical steroid sprays are the most evidence supportive. Nonstandard topical nasosinusal steroid therapies may be an option for managing CRS.
{"title":"Nasal washes in chronic rhinosinusitis, review article","authors":"A. Benítez, S. Toso, C. Mena, E. Pérez","doi":"10.32457//ijmss.v10i1.2087","DOIUrl":"https://doi.org/10.32457//ijmss.v10i1.2087","url":null,"abstract":"Chronic rhinosinusitis (CRS) is a chronic condition of inflammation in the mucosa of the paranasal sinuses that is associated with a significantly impaired quality of life, which motivates the constant study of therapies for its control and cost reduction. The cutting edge of clinical management for CRS is topical therapy. The advantages of topical medical therapy include direct administration of the drug into the diseased tissue, the possibility of administering higher local concentrations of the drug and minimizing systemic absorption which is not without adverse effects, thus becoming an important strategy in the management of CRS. The objective of this literature review is to formally review and identify topical medical therapy strategies and promote an evidence-based approach to their use. A literature review was conducted based on a keyword search. The computerized databases of PubMed, ElSevier and ResearchGate were accessed. We included articles highlighting the results of the use of topical therapies in CRS and that the type of study was a clinical trial. This review identified and evaluated the literature on topical therapy strategies for CRS: saline irrigation, topical antibiotics, topical steroids, and topical antifungals. Topical therapy has become an important tool in the treatment arsenal for CRS. Based on a review of the literature, nasal irrigation with saline and topical steroid sprays are the most evidence supportive. Nonstandard topical nasosinusal steroid therapies may be an option for managing CRS.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81878235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-29DOI: 10.32457/ijmss.v10i1.2087
Alicia Benítez, Sandra Toso, Carlos Mena, Enrique Pérez
Chronic rhinosinusitis (CRS) is a chronic condition of inflammation in the mucosa of the paranasal sinuses that is associated with a significantly impaired quality of life, which motivates the constant study of therapies for its control and cost reduction. The cutting edge of clinical management for CRS is topical therapy. The advantages of topical medical therapy include direct administration of the drug into the diseased tissue, the possibility of administering higher local concentrations of the drug and minimizing systemic absorption which is not without adverse effects, thus becoming an important strategy in the management of CRS. The objective of this literature review is to formally review and identify topical medical therapy strategies and promote an evidence-based approach to their use. A literature review was conducted based on a keyword search. The computerized databases of PubMed, ElSevier and ResearchGate were accessed. We included articles highlighting the results of the use of topical therapies in CRS and that the type of study was a clinical trial. This review identified and evaluated the literature on topical therapy strategies for CRS: saline irrigation, topical antibiotics, topical steroids, and topical antifungals. Topical therapy has become an important tool in the treatment arsenal for CRS. Based on a review of the literature, nasal irrigation with saline and topical steroid sprays are the most evidence supportive. Nonstandard topical nasosinusal steroid therapies may be an option for managing CRS.
{"title":"Nasal washes in chronic rhinosinusitis, review article","authors":"Alicia Benítez, Sandra Toso, Carlos Mena, Enrique Pérez","doi":"10.32457/ijmss.v10i1.2087","DOIUrl":"https://doi.org/10.32457/ijmss.v10i1.2087","url":null,"abstract":"Chronic rhinosinusitis (CRS) is a chronic condition of inflammation in the mucosa of the paranasal sinuses that is associated with a significantly impaired quality of life, which motivates the constant study of therapies for its control and cost reduction. The cutting edge of clinical management for CRS is topical therapy. The advantages of topical medical therapy include direct administration of the drug into the diseased tissue, the possibility of administering higher local concentrations of the drug and minimizing systemic absorption which is not without adverse effects, thus becoming an important strategy in the management of CRS. The objective of this literature review is to formally review and identify topical medical therapy strategies and promote an evidence-based approach to their use. A literature review was conducted based on a keyword search. The computerized databases of PubMed, ElSevier and ResearchGate were accessed. We included articles highlighting the results of the use of topical therapies in CRS and that the type of study was a clinical trial. This review identified and evaluated the literature on topical therapy strategies for CRS: saline irrigation, topical antibiotics, topical steroids, and topical antifungals. Topical therapy has become an important tool in the treatment arsenal for CRS. Based on a review of the literature, nasal irrigation with saline and topical steroid sprays are the most evidence supportive. Nonstandard topical nasosinusal steroid therapies may be an option for managing CRS.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"55 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134952738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background and Aim Surgery for malleolar fractures is associated with severe pain. Ultrasonography-guided nerve blocks have quality, precision, and drug dose reduction but are not preferred over spinal anesthesia. We have conducted a study to compare the effectiveness of femoropopliteal block with spinal anesthesia. Objective The aim of this study was to compare onset, duration, and hemodynamic variability and total analgesic requirement of femoropopliteal block with spinal anesthesia. Methods Preoperatively patients were divided into two groups (30 in each): Group 1—patients receiving spinal anesthesia with 0.5% hyperbaric bupivacaine; Group 2—patients receiving 15 mL in popliteal block and 5 mL in femoral block of 20 mL 0.5% bupivacaine with 8 mg dexamethasone. Onset, duration, hemodynamic changes, and postoperative analgesia requirements were monitored. Results Mean onset of sensory blockade in group 1 and 2 was 3.83 ± 0.92 and 12.68 ± 3.03 minutes ( p -value <0.001.) and motor blockade in group 1 and 2 was 5.36 ± 1.7 and 12.68 ± 3.03 minutes ( p -value <0.01), respectively. Mean duration of analgesia in group 1 and 2 was 3 ± 1.31 and 20.2 ± 4.7 hours, respectively. None of the patients in group 2 and 3% in group 1 had hypotension and bradycardia ( p -value > 0.05). The mean dose of morphine required in group 1 and 2 was 20.3 ± 2.1 and 3.56 ± 0.02 mg in 24 hours ( p -value < 0.001), respectively. Conclusion Femoropopliteal block was slower in onset but produced longer postoperative analgesia with markedly reduced opioid consumption.
背景与目的外踝骨折的手术治疗伴有严重的疼痛。超声引导下的神经阻滞具有质量、精度和药物剂量减少的优点，但不如脊髓麻醉好。我们进行了一项研究，比较股腘动脉阻滞与脊髓麻醉的有效性。目的比较脊髓麻醉与股腘动脉阻滞的起始时间、持续时间、血流动力学变异性和总镇痛需求。方法术前将患者分为两组，每组30例:第一组:0.5%布比卡因高压压腰麻;2组患者接受0.5%布比卡因20 mL +地塞米松8 mg的腘窝阻滞15 mL，股动脉阻滞5 mL。监测发病、持续时间、血流动力学变化和术后镇痛需求。结果1、2组感觉阻滞发作时间平均为3.83±0.92分钟，12.68±3.03分钟(p值均为0.05)。1、2组小鼠24h吗啡平均需药量分别为20.3±2.1、3.56±0.02 mg (p值< 0.001)。结论股腘静脉阻滞起效较慢，术后镇痛时间较长，阿片类药物用量明显减少。
{"title":"A Comparison of Femoropopliteal Block versus Spinal Anesthesia for Malleolar Surgeries","authors":"R. Sugathan, Reeba Mariya Mathews, Venugopalan Pg","doi":"10.1055/s-0043-1761505","DOIUrl":"https://doi.org/10.1055/s-0043-1761505","url":null,"abstract":"Abstract Background and Aim Surgery for malleolar fractures is associated with severe pain. Ultrasonography-guided nerve blocks have quality, precision, and drug dose reduction but are not preferred over spinal anesthesia. We have conducted a study to compare the effectiveness of femoropopliteal block with spinal anesthesia. Objective The aim of this study was to compare onset, duration, and hemodynamic variability and total analgesic requirement of femoropopliteal block with spinal anesthesia. Methods Preoperatively patients were divided into two groups (30 in each): Group 1—patients receiving spinal anesthesia with 0.5% hyperbaric bupivacaine; Group 2—patients receiving 15 mL in popliteal block and 5 mL in femoral block of 20 mL 0.5% bupivacaine with 8 mg dexamethasone. Onset, duration, hemodynamic changes, and postoperative analgesia requirements were monitored. Results Mean onset of sensory blockade in group 1 and 2 was 3.83 ± 0.92 and 12.68 ± 3.03 minutes ( p -value <0.001.) and motor blockade in group 1 and 2 was 5.36 ± 1.7 and 12.68 ± 3.03 minutes ( p -value <0.01), respectively. Mean duration of analgesia in group 1 and 2 was 3 ± 1.31 and 20.2 ± 4.7 hours, respectively. None of the patients in group 2 and 3% in group 1 had hypotension and bradycardia ( p -value > 0.05). The mean dose of morphine required in group 1 and 2 was 20.3 ± 2.1 and 3.56 ± 0.02 mg in 24 hours ( p -value < 0.001), respectively. Conclusion Femoropopliteal block was slower in onset but produced longer postoperative analgesia with markedly reduced opioid consumption.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"191 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82301045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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