Objectives:To compare the results of tympanoplasty alone and tympanoplasty with cortical mastoidectomy in chronic suppurative otitis media (CSOM) patients with sclerotic bone in terms of graft uptake, perforation closure, improvement in hearing and disease eradication. Study Design:Retrospective study of patients at tertiary referral hospital.Method: 50 cases of non-cholesteatomatous chronic suppurative otitis media were selected.Tympanoplasty alone was done in 25 cases and tympanoplasty combined with cortical mastoidectomy was done in another 25 cases.Patients were reviewed postoperatively at 4, 8 and 12 weeks to inspect the operated ear for graft uptake or any complication.Pure tone audiometry(PTA) was done at 2 nd and 4 th month to evaluate the hearing improvement.Results: In our study, hearing gain in decibel ( dB ) in tympanoplasty group was 7.64 and in tympanoplasty combined with cortical mastoidectomy was 8.84.Graft uptake was 76% in tympanoplasty group and 88% in tympanoplasty combined with cortical mastoidectomy.Recurrence of discharge was seen in 2 cases of tympanoplasty.Though tympanoplasty combined with cortical mastoidectomy is better in hearing improvement, graft uptake and clinical improvement but the difference in 2 groups is statistically insignificant. Conclusion:Hearing improvement, graft uptake and clinical improvement were statistically incomparable in 2 groups.Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain, disease clearance and graft uptake.
Fracture of the tubes appears to be caused by their prolonged use and defective fusion at the junction of cannula and phalange. We report here three cases of fractured polyvinyl chloride tracheostomy tube, an unusual complication of tracheostomy, presenting as foreign body in the trachea.
Background: Urinary calculi are commonly diagnosed as a consequence of an episode of renalureteral colic or gross hematuria.Clinical manifestations are characterized by lumbar pain of sudden onset that may be accompanied by nausea and vomiting, gross or microscopic hematuria.Objectives: To study clinical trends of urolithiais in the rural population. Material and methods:The present prospective randomized study was conducted on 80 patients with clinically and radiologicaly suspected cases with urinary calculi in the department of Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research Mullana-Ambala during the period of two years (Oct 2010-Sep 2012).All the cases with urinary calculi were admitted.Detailed history including present complaints were taken.General physical examination as well as systemic examination was done in all the cases.Investigations including routine as well as special investigations were performed and all the cases were managed according to preset proforma.All the data obtained was recorded and analysed according to the preset proforma.Results: Majority of patients in present study were admitted with the complaint of pain (96.3%), burning micturition (85%) and fever (77.5%).30% patients had gross haematuria and around 11.25% of patients were admitted as acute retention of urine.All patients in present study when physically examined had shown the tenderness of varying severity according to the location and site of the Urinary calculi.In majority (41.3%) tenderness was present in Rt flank/ iliac fossa.Suprapubic tenderness was present in only 12.5% of cases.Conclusion: These patients mostly present with acute episodes of pain and burning micturition.Haematuria is less common way of presentation here.This study was an attempt to highlight the prevalence of urolithiasis in this belt and warrants the more exhaustive research in this regards.
In order to develop and test a treatment, researchers measure an ‘outcome’. For example the ‘outcome’ might include a measure of how fast a white patch gets its color back (repigmentation) in vitiligo. Vitiligo is a skin condition, which causes white patches of the skin and sometimes hair. Currently, there is no cure nor firm clinical recommendations for the treatment of vitiligo. One of the main reasons behind this is that different studies measure different outcomes; therefore the studies can't be combined and compared. Recently, the International INitiative for Outcomes for vitiligo (INFO for vitiligo), which includes patients, their caregivers, medical journal editors and doctors from over 24 countries worldwide, have come to an agreement over a set of outcomes for vitiligo, which should be measured in every trial: repigmentation of skin lesions, side effects/harms of treatment and how long the colour stays after repigmentation of vitiligo lesions has occurred. Still, there was no agreement amongst patients and clinicians on which scale (outcome measure) should be used to measure repigmentation. This means that even if all the future trials measure repigmentation, but use different scales to do so, study results still can't be combined and compared. This international study was conducted with an aim to define successful repigmentation from patients’ point of view and propose how and when repigmentation should be evaluated in clinical trials in vitiligo. The authors conducted 3 workshops with vitiligo patients and their parents/care givers in the U.S.A. 73 participants were recruited. “Successful repigmentation” from patients’ perspective means achieving over 80% of repigmentation in a vitiligo patch. Both percentage of repigmentation quartiles (0‐25%, 26‐50%, 51‐79%, 80‐100%) and cosmetic acceptability of the results from patients’ point of view, should be measured in every trial. In conclusion, this was the largest patients’ outcomes workshop. Unity among the researchers on using the same scales to measure repigmentation in future trials will bring richer data and therefore clearer clinical recommendations.