JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH最新文献

{"title":"Comparison of Safety and Efficacy of Unilateral Spinal Anaesthesia and Ultrasound-guided Sciatic Femoral Nerve Block in below Knee Surgery: A Randomised Clinical Study","authors":"Dhara M Shah, Bipin K Shah, Shruti Desai, Sarala C Baria","doi":"10.7860/jcdr/2023/64681.18653","DOIUrl":"https://doi.org/10.7860/jcdr/2023/64681.18653","url":null,"abstract":"Introduction: With modern advances, Ultrasonography (USG)- guided regional block techniques have improved nerve blockade with lesser drug usage and maximum safety for patient care. The widely appreciated outpatient surgical care has compelled us to apply the fastest and safest anaesthesia technique. For lower limb surgeries, USG-guided Sciatic Femoral Nerve Block (SFNB) is an emerging alternative to Spinal Anaesthesia (SA). Aim: To compare the safety and efficacy of both techniques in terms of haemodynamic stability, quality of block, and postoperative analgesia. Materials and Methods: A randomised double-blind study conducted at GCS Medical College, Hospital, and Research Centre, Ahmedabad, Gujarat, India, on 80 patients aged 18 to 70 years of either sex, with American Society of Anaesthesiology (ASA) Grade 1 to 3, undergoing below-knee surgeries was divided into two groups. Group A received USA with 1.5 mL hyperbaric inj. ropivacaine 0.75%, and Group B received USGguided SFB with inj. ropivacaine 0.5% 30 mL (15 mL for sciatic nerve and 15 mL for femoral nerve block). Preparation Time (PT), Surgical Anaesthesia Time (SAT), haemodynamic changes, quality of block, Longevity of Anaesthesia (LoA), time of first rescue analgesia, time of spontaneous urination, readiness to discharge, and patient satisfaction were recorded. The statistical analysis was carried out using Statistical Package for Social Sciences version 23.0 (SPSS Inc., Chicago II, USA). The p-value was derived by unpaired t-test and Chi-square test. Results: PT and SAT were higher in Group B (12.10±2.02 mins and 15.74±1.58 mins) than in Group A (6.15±1.12 mins and 8.23±1.45 mins). LoA time and time to first rescue analgesic were higher in Group B (284.10±54.44 mins and 265.71±33.69 mins) than in Group A (138.75±23.30 mins and 132.40±17.41 mins). Time to first spontaneous urination and readiness to discharge were shorter in Group B (136.42±18.40 mins and 158.39±10.78 mins) than in Group A (162.20±26.54 mins and 181.53±18.18 mins). Haemodynamic stability was excellent in both groups with no significant fluctuation. Motor blockade of Bromage 3 grade was achieved in 40 and 38 patients in Group A and B, respectively. The development of VAS score >3 was faster in Group A than in Group B (35 versus 2) at the end of three hours. No adverse events were observed in any patient. Conclusion: USG-guided SFB offers a safe and efficient alternative to Unilateral SA (USA) with satisfactory blockage, stable haemodynamics, and better postoperative analgesia for below-knee surgeries.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135609941","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}

{"title":"Usefulness of Endoscopic Ultrasound for the Detection of Asymptomatic Pancreatic Morphological Changes in Patients with Alcoholic Liver Disease: A Cross-sectional Study","authors":"Pankaj Gupta, Dinesh Agarwal, Anurag Govil, Harsh Udawat","doi":"10.7860/jcdr/2023/65188.18396","DOIUrl":"https://doi.org/10.7860/jcdr/2023/65188.18396","url":null,"abstract":"Introduction: Although alcoholism is a common aetiological link between liver and pancreatic disorders, the frequency of coinciding pancreatic disease in patients with alcohol-related liver disease is not well understood. The present study mentions about the use of Endoscopic Ultrasound (EUS) with standardised criteria to assess asymptomatic or overt pancreatic pathology in patients with alcoholic liver disease. Aim: To determine the prevalence of asymptomatic Alcoholic Chronic Pancreatitis (ACP) in Indian patients affected by Alcoholic Liver Cirrhosis (ALC) using EUS. Materials and Methods: The present observational crosssectional study was conducted on patients attending the Outpatient Department of Gastroenterology at Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Jaipur, Rajasthan, India. A total of 35 patients were screened with alcoholic liver disease for pancreatic abnormalities using EUS. The patients were recruited for the study over a period of 12 months, from September 2013 to August 2014. The prevalence of chronic pancreatitis (CP) was determined, and abnormalities were graded according to the Rosemont criteria. The severity of alcoholic liver disease, as indexed by Child Pugh Scoring (CPS) and Model for End-stage Liver Disease (MELD), was evaluated for any association with endosonographic findings of CP. The influence of various clinico-demographic factors on alcoholic liver and pancreatic diseases was analysed using the PSS Inc. Chicago, IL program. Results: A total of 35 male patients, aged 28 to 65 years with a mean age of 46.97 years, fulfilled the inclusion criteria. EUS revealed a prevalence of CP in 20% of patients. Three patients showed changes suggestive of CP, of which two had ALC and one had Alcoholic Hepatitis (AH). Four patients were prioritised in categorised as indeterminate for CP, with three having cirrhosis and one having Alcoholic Fatty Liver (ALF). No significant influence of clinico-demographic profiles on the final outcome parameters was observed. The patient with endoscopic changes had a MELD score of 12.85±5.11 compared to patients without changes of ACP (19.1±5.71) (p=0.013). ALC was found to be inversely related to EUS changes of ACP. Conclusion: The EUS is an effective screening tool for evaluating pancreatic abnormalities in patients with alcoholic liver disease. The present study provides a comprehensive review of previous findings in light of the varying facts and figures. As there is still a lack of experimental animal models for ALC and ACP, studies of this kind may shed light on hidden links in disease pathology.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649977","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}

{"title":"A Rare Case of Tuberculosis in the Lumbar Facet Joint","authors":"Vijayanand Balasubramanian, Parth Mehta, Rajavel Kalirajan","doi":"10.7860/jcdr/2023/62666.18400","DOIUrl":"https://doi.org/10.7860/jcdr/2023/62666.18400","url":null,"abstract":"Tuberculosis of the posterior elements is a rare and destructive form characterised by the destruction of the lamina, pedicle, or facet joints. Delay in clinical diagnosis and presentation is common because of poor visualisation of facet joints in X-rays. A 55-year-old male presented with back and left leg pain lasting for six months, accompanied by weakness in dorsiflexion of the left foot and ankle. Magnetic Resonance Imaging (MRI) revealed features suggestive of L4-L5 facetal arthritis on the left side, including marrow oedema, bone erosions, a posterior paraspinal abscess, and nerve root compression. The patient underwent posterior decompression and stabilisation, along with abscess drainage. The specimen was sent for histopathological examination, confirming the diagnosis of facetal joint tuberculosis. Antituberculous treatment was given for 12 months, that showed improved neurological status. This case is presented due to its rarity, highlighting the importance of considering facetal joint tuberculosis as a potential cause in cases of progressively increasing lower back pain, even in the absence of constitutional symptoms.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650562","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}

{"title":"Analysis of Postoperative Complications of Minimally Invasive Surgery for Carcinoma of Oesophagus: A Single Centre Retrospective Cohort Study","authors":"Sonai Datta Kakati, Dokne Chintey, Gaurav Das, Marie Ninu","doi":"10.7860/jcdr/2023/65468.18472","DOIUrl":"https://doi.org/10.7860/jcdr/2023/65468.18472","url":null,"abstract":"Introduction: Traditional transthoracic oesophagectomy is associated with high perioperative morbidity. Minimally Invasive Oesophagectomy (MIE) techniques have been shown to have a decreased incidence of respiratory complications and an improvement in perioperative outcomes, such as length of hospital stay and wound infection rates. Aim: To evaluate the incidence of postoperative respiratory complications, 30-day mortality, and length of hospital stay among patients with carcinoma of the oesophagus undergoing, VideoAssisted Thoracoscopic Surgery (VATS) oesophagectomy. Materials and Methods: A cross-sectional study was conducted in the Department of Anaesthesiology in a new thoracic oncology unit at a Tertiary Cancer care centre, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India. A total of 67 patients with resectable oesophageal cancer who underwent VATS oesophagectomy from September 2019 to December 2021 were included. Patients who had surgery by open thoracotomy and inoperable cases were excluded. The patients’ clinicodemographic profile, intraand postoperative variables, and complications were studied. Descriptive statistics were used for analysis. A p-value ≤0.05 was considered statistically significant at a 5% level of significance. Results: Out of 67 patients, 45 (67.2%) were male, and 22 (32.8%) were female. The age ranged from 33 to 78 years with a median age of 55 years (IQR 47-61). The median body weight was 45 kg (IQR 42-53). Nineteen (28.4%) patients developed postoperative complications, including respiratory distress in 7 (10.4%) and anastomotic leakage in 5 (7.5%) patients. Other complications included symptomatic Coronavirus Disease 2019 (COVID-19) infection, pneumonia, mediastinitis, Multiorgan Dysfunction Syndrome (MODS) with sepsis, seizure and cardiac arrest, and surgical re-exploration. The 30-day mortality was 2.98%. The median length of hospital stay was 19 days (Interquantile Range (IQR) 16-22), which was higher in those with complications (p<0.001). One-lung ventilation was associated with a higher risk of postoperative respiratory complications (p=0.077). Conclusion: VATS oesophagectomy, even in a new thoracic oncology unit, was associated with lower perioperative complications, a shorter hospital length of stay, and decreased mortality compared to historical controls.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053370","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}

{"title":"Preoperative Clonidine with Perioperative Dexmedetomidine for Attenuating Haemodynamic Responses and Blood Loss in Patients Undergoing Elective Transnasal Transsphenoidal Resection of Pituitary Tumours: A Randomised Clinical Study","authors":"Ravindra Singh Sisodia, Sunita Sharma, Medha Bhardwaj, Akansha Garg, Vijay Mathur","doi":"10.7860/jcdr/2023/65917.18473","DOIUrl":"https://doi.org/10.7860/jcdr/2023/65917.18473","url":null,"abstract":"Introduction: Transsphenoidal resection of pituitary tumours presents challenges for an anaesthesiologist due to haemodynamic fluctuations caused by intense nociceptive stimuli during different surgical stages. This relatively short procedure requires a smooth and rapid emergence for spontaneous airway control and assessment of surgical outcomes. Therefore, the chosen anaesthetic agent should provide effective haemodynamic control and facilitate rapid recovery. Alpha-2 agonists such as dexmedetomidine and clonidine are known to centrally decrease noradrenaline release, thus reducing sympathetic outflow. This could be particularly beneficial in minimising haemodynamic fluctuations during such surgeries. Aim: To compare the effects of preoperative clonidine and perioperative dexmedetomidine in attenuating haemodynamic responses and blood loss in patients undergoing elective Transnasal Transsphenoidal resection (TNTS) of pituitary tumours. Materials and Methods: A randomised, double-blinded study was conducted in the Department of Neuroanesthesiology at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India, over a period of one year, from February 2022 to January 2023. Sixty patients of either sex, aged 18-65 years with ASA I or II, scheduled for elective TNTS pituitary surgery, were enrolled and divided into group A and group B. Group A received clonidine tablets (3 mcg/kg) 180 minutes prior to surgery, while group B received intravenous (i.v.) infusion of dexmedetomidine (1 mcg/kg/min) over 10 minutes before induction, followed by 0.5-0.7 mcg/kg/hr. Group A received a placebo of 0.9% Normal Saline (NS) (50 mL). Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) were recorded at baseline, intubation, nasal pack insertion, endoscope insertion, and at various time intervals. Data obtained were analysed using unpaired sample t-test for independent groups, and Chi-square test was used for categorical data. A probability value of 0.05 was considered significant for both statistical tests. Results: The mean age of participants was 42±11 years for group A and 43±12 years for group B, with a male: female ratio of 66.6% to 33.3% in group A and 70% to 30% in group B, respectively. The mean Body Mass Index (BMI) was 26.4±3.2 in group A and 25.2±1.7 in group B. HR, SBP, and MAP decreased at various stages in group B compared to group A, and these differences were statistically significant (p-value &lt;0.05). The study also found that the total consumption of propofol was significantly less in group B (220±38) compared to group A (282±140). Similarly, total fentanyl consumption was significantly lower in group B (5.83±1.60) than in group A (16.6±23.9). Although not statistically significant, total blood loss was also lower in group B (115±63) compared to group A (156±108). Conclusion: Intraoperative infusion of i.v. dexmedetomidine provides a reasonable choice compared to orally administ","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"2020 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053376","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}

{"title":"Treatment Outcome of Tuberculosis in Patients with Diabetes under RNTCP in a Tertiary Care Centre, Chengalpattu, India: A Prospective Cohort StudyTreatment Outcome of Tuberculosis in Patients with Diabetes under RNTCP in a Tertiary Care Centre, Chengalpattu, India: A Prospective Cohort Study","authors":"P Parameshwari, Sanjai ., Niveditha ., Preetha ., H Gladius Jennifer, Latha Durai","doi":"10.7860/jcdr/2023/64830.18475","DOIUrl":"https://doi.org/10.7860/jcdr/2023/64830.18475","url":null,"abstract":"Introduction: Diabetes increases the risk of Tuberculosis (TB) by three times, and this bidirectional association is currently one of the major concerns. A stronger evidence base is required to clarify the impact of Diabetes Mellitus (DM) on the treatment outcome of TB. Aim: To compare the treatment outcome among diabetic and non diabetic patients on Category-I TB treatment based on the Revised National Tuberculosis Control Program (RNTCP). Also, to assess the various factors influencing the treatment outcome of TB among diabetic patients. Material and Methods: A prospective cohort study was conducted on 75 newly diagnosed TB patients enrolled for Category-I treatment Department of Pulmonary Medicine, Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India, between October 2018 to November 2019. All patients with TB underwent blood glucose screening at treatment initiation and were categorised into two groups: with diabetes and without diabetes. Demographic details, family history of DM, smoking, alcohol consumption, and clinical profile were collected using a semi-structured questionnaire and followed-up for six months to assess their treatment outcome. The treatment outcome was compared statistically based on diabetes status using the Chi-square test. Results: The mean age of the study population was 49.9±0.5 years, with the majority being male 56 (74.7%). More than half of the study population belonged to a low socio-economic status. Among the study population, 42 (56%) were diabetic, with a mean blood glucose level of 242.7±80.5 mg/dL. Eighty-two percent had Pulmonary TB, with a 68% smear positivity rate among diabetic patients. In terms of treatment outcome, 44 (58.7%) were cured, 15 (20%) completed treatment, 10 (13.3%) were lost to followup, and 6 (8%) expired during the treatment course. Conclusion: Smear positivity and pulmonary TB were predominant among patients with diabetes. Treatment completion was lower, and mortality was higher among diabetic patients with TB.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053636","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}

{"title":"Perception of First Year Medical Students towards a New Histology Module in a Medical College in Eastern India: A Quasi-Experimental Study","authors":"Rituparna Basu, Tapati Roy","doi":"10.7860/jcdr/2023/62532.18474","DOIUrl":"https://doi.org/10.7860/jcdr/2023/62532.18474","url":null,"abstract":"Introduction: The post-COVID (Coronavirus) era, the transition of our country towards a competency-based curriculum, and our fundamental goal to improve students’ learning experience and academic performance expedite the need to introduce new strategies to the existing teaching-learning method based on principles of medical education in the form of a structured module. Among all subdivisions of anatomy, this is especially relevant for histology because microscopic anatomy poses a basic difficulty associated with the comprehension of microscopic details of human tissues through the novice, untrained eyes of the freshly-admitted first-year medical students. Aim: To study the perception of first year medical students towards the new histology teaching module. Materials and Methods: This quasi-experimental study was conducted among 85 first year medical students of Medical College, Kolkata, from May 2022 to October 2022, on histology teaching methods, comparing new histology modules versus traditional histology methods. A student survey was conducted to study their perception regarding the difficulties faced by them during their first-semester histology practical examination. After conducting a literature search, a new learner-centered histology module was designed and implemented among students to address these difficulties. Forty-eight histology sessions were conducted using the new module over a total duration of six months. Students’ feedback regarding the new module was recorded at the end of the sixth month. The collected data was analysed using Statistical Package for the Social Science (SPSS) software version 22.0 (trial version). Results: A total of 84 (98.8%) of students strongly agreed that because of the preliminary self-study time followed by discussions, quizzes, and brainstorming during the histology sessions, they had an improved understanding of the assigned learning areas. Additionally, 81 (95.3%) of students strongly agreed that their drawing skills of histology diagrams had improved due to drawing practice during the sessions. Furthermore, 83 (97.6%) of students reported an improvement in focusing and correctly identifying slides. Moreover, 82 (96.4%) of students felt that the regular formative assessments and immediate feedback improved their readiness for histology examinations. All of them agreed to the continued practice of the new module in future histology sessions. Conclusion: The students’ response towards the module was found to be positive. Addressing the students’ recommendations in the future would increase the chances of generating more support for it and enhancing their motivation towards improved academic performance in histology examinations.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"2020 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053639","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}

{"title":"Intraluminal Submucosal Lipoma as a Lead Point Causing Colo-colic Intussusception: A Case Report","authors":"Azhar Shoaib Shaikh, Sandeep Anil Dhote, Suresh Vasant Phatak, Avinash Parshuram Dhok, Prashant Madhukarrao Onkar","doi":"10.7860/jcdr/2023/64072.18489","DOIUrl":"https://doi.org/10.7860/jcdr/2023/64072.18489","url":null,"abstract":"Adult colo-colic intussusception is very rare and it poses a diagnostic challenge in the geriatric population. The clinical diagnosis can be difficult due to non specific presenting complaints. However, it is a surgical emergency with high morbidity and mortality rates. Surgical exploration is the recommended treatment as most cases involve a pathological lead point. In this case report, the authors present the case of a 50-year-old female patient who complained of pain in the left lumbar region, loose stools, and loss of appetite for one month. Ultrasound (US) revealed an echogenic mass with a typical bowel within-bowel appearance. Contrastenhanced Computed Tomography (CECT) of the abdomen showed telescoping of the proximal descending colon into the distal descending colon. Additionally, a fat density rounded lesion was observed on CT. The wall of the descending colon exhibited enhancement, indicating viable large bowel loops. Colonoscopy revealed a polypoid growth. The patient subsequently underwent surgery, confirming all imaging findings. Resection and anastomosis of the colon were performed, with an intraluminal lipoma identified as the primary cause of the colo-colic intussusception. The postoperative period of up to three months was uneventful. US and CT play a crucial role in the early diagnosis and prevention of serious complications.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"37 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258628","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}

{"title":"Evaluation of the Effectiveness of Topical Anaesthetic Gel and Needle Free Jet Anaesthesia in Root Planing: A Cross-sectional Study","authors":"Bhavya Shetty, Khadijathul Irfana, Ibrahim Fazal, Irfana Shabeeba","doi":"10.7860/jcdr/2023/59110.17458","DOIUrl":"https://doi.org/10.7860/jcdr/2023/59110.17458","url":null,"abstract":"Introduction: Although traditional local anaesthetic technique by injection is considered as gold standard for dental procedure, the resultant pain and anxiety caused by the needle prick makes the patient less compliant for further treatment. Many alternatives have been developed by the researchers in the last two decades. Jet anaesthesia and the topical gel are the commonly used alternatives to anaesthetise the local area. Aim: To evaluate and compare the effectiveness of topical anaesthetic gel (MucopainR gel) and jet anaesthesia (Sure ShotR needle free jet injection) during root planing. Materials and Methods: After taking consent, 20 patients who required root planning in the maxillary quadrant bilaterally were recruited for this study. A split mouth study was planned where one quadrant was anaesthetised with benzocaine 20% (MucopainR) gel, whereas sure shotR jet anaesthesia was used on the adjacent quadrant. The side and order of placement of topical gel and jet anaesthesia were randomised. The same operator delivered anaesthesia on both the sides. The root planning was carried out by another operator at two sittings and pain was assessed immediately using Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and Verbal Response Scale Statistical . Results: The mean NRS score of the jet injection group was 1.50±1.54 and that for the gel group was 3.15±2.16. Also, the mean VAS score of the jet injection group was 1.50±1.54 and that for the gel was 3.15±2.16. The difference between two groups were statistically significantly (p-value=0.008). Conclusion: Jet anaesthesia was significantly superior to gel in providing anaesthesia during root planing.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"113 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89175200","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}

{"title":"Suprapatellar versus Infrapatellar Approach for Intramedullary Nailing in Tibial Shaft Fractures: A Prospective Interventional Study","authors":"G. Sahni, Sukhjot Singh, Ashish Kavia, H. Aggarwal, H. Chawla","doi":"10.7860/jcdr/2023/55398.17258","DOIUrl":"https://doi.org/10.7860/jcdr/2023/55398.17258","url":null,"abstract":"Introduction: Tibial diaphyseal fractures are the most prevalent type of tibia fracture. A well known surgical method for treating tibial shaft fractures was the traditional infrapatellar approach for tibia Intramedullary Nailing (IMN). However, due to increased valgus and procurvatum deformities, IMN insertion through the infrapatellar route poses problems. Recently, suprapatellar nailing in the semi-extended position has been promoted as a safe and effective surgical treatment. Aim: To compare the clinical and functional outcomes of tibial shaft fractures treated with IMN utilising the Suprapattelar (SP) and Infrapatellar Methods (IP). Materials and Methods: A prospective interventional study was conducted on 40 patients, in the Department of Orthopaedics, in Government Medical College, Patiala ,Punjab, India from November 2019 to May 2021. The patients were divided into two groups on the basis of tibial shaft fractures treated with IMN utilising the S.P and those treated with I.P techniques during a two year period (20 in each group) with six months followup. Group A patients were treated with IMN in tibia through suprapatellar technique and group B Patients were treated with IMN in tibia via infrapatellar approach. The outcomes of IMN in tibial shaft fractures via SP and IP approach were compared in terms of fluoroscopy time, average surgical time, anterior knee pain using Visual Analogue Scale (VAS) score, average blood loss, fracture union time and functional outcome (in terms of the lower extremity functional Score). For statistical analysis student t-test and chi-square test was used, p-value <0.05 was considered as significant. Results: There were significant differences between SP and IP IMN in terms of fluoroscopy duration (94.25 vs 129.40 seconds, p-value-0.001), anterior knee pain (VAS score) (19.65 vs 29.85, p-value-0.001), average blood loss (49.30 vs 62.45 mL, p- value 0.001), and functional result (75.45 vs 70.05, p-value=0.001). The fracture union time between the two groups was non significant (90.50 vs 90.30 days, p-value=0.876). Conclusion: In terms of fluoroscopy time, anterior knee pain, average blood loss, and knee ratings, the SP technique was superior to the IP strategy.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"104 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87626403","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}