Search

This phase III trial evaluated whether the no touch was superior to the conventional in patients with cT3/T4 colon cancer.No touch involves ligating blood vessels that feed the primary tumor to limit cancer cell spreading. However, previous studies did not confirm the efficacy of the no touch.This open-label, randomized, phase III trial was conducted at 30 Japanese centers. The eligibility criteria were histologically proven colon cancer; clinical classification of T3-4, N0-2, andM0; and patients aged 20 to 80years. Patients were randomized (1:1) to undergo open surgery with conventional or the no touch. Patients with pathological stage III disease received adjuvant capecitabine chemotherapy. The primary endpoint was disease-free survival (DFS) according to the intention-to-treat principle.Between January 2011 and November 2015, 853 patients were randomized to the conventional group (427 patients) or the no touch group (426 patients). The 3-year DFS were 77.3% [95% confidence interval (CI) 73.1%-81.0%] and 76.2% (95% CI 71.9%-80.0%) in the conventional and no touch groups, respectively. The superiority of no touch was not confirmed: hazard ratio for DFS = 1.029 (95% CI 0.800- 1.324; 1-sided P = 0.59). Operative morbidity was observed in 31 of 427 conventional patients (7%) and 26 of 426 no touch patients (6%). All grade adverse events were similar between the conventional and no touch groups. No in-hospital mortality occurred in either group.The present study failed to confirm the superiority of the no touch.

Objectives: now a days recent intraoral scanners (IOS) are ready for digital scans of long-span edentulous patients and completely edentulous patients ; however, there is lacking of evidence. In recent years there is vigorously promoted of digitization in the dental field .there is a significant transformation in the future of dentistry by using the intra oral scanner to have digital impression. The aim of this article to evaluated the deviation between of intraoral scanning (IOS) impression and conventional impression in completely edentulous patient and to analyze the accuracy of IOS in completely edentulous maxillary arch. MATERIALS AND METHODS: Two types of impression technique were made for eight completely edentulous patients. Intra oral scanning and conventional impression technique of the maxilla was done for each patient, the two-impression techniques were compared for accuracy using GOM inspect software. Result: Total deviation between two groups were compared to hypothesized zero representing conventional impression I group and then calculated using special inspection software. The total deviation was statistically significantly different among the studied groups. Conclusion: The accuracy of IOS not reliable for completely edentulous arches

Objective: To evaluate the effect of application of delayed split expansion technique without guided bone regeneration for implant placement in narrow posterior mandibular ridge. Patients and methods: Fourteen patients with narrow posterior mandibular ridge were included in this prospective study. All patients treated by a two-stage split technique with implant placement, receiving a total of thirty implants. All patients were evaluated clinically and radiographically by multi-slice CT scan. The width of the alveolar ridge was measured before implantation, immediately after implantation, and after 6 months. Marginal bone loss was calculated buccally and lingually as the difference between bone height measurements immediately post-implant insertion and after 6 months. Results: The average increase of the alveolar ridge width was 4.22±0.94 mm after 6 months, which showed a high statistically significant value (P ≤0.001). The mean values of buccal and lingual marginal bone loss were 0.403±0.26 and 0.217±0.20 mm respectively, which showed statistically non-significant values (P=0.087 and P= 0.092 respectively). Conclusion: The use of delayed expansion technique without guided bone regeneration is a simple efficient technique for horizontal augmentation of the narrow posterior mandibular ridge for implant placement. It offers less incidence of complications, less morbidity, and cost than other augmentation techniques. It represents a modification of the conventional technique and is especially interesting for those patients with highly compact bone and initial insufficient bone ridge width for implant placement.

Purpose To compare the effects of femtosecond laser assisted cataract surgery (FLACS) and manual phacoemulsification on cumulative dissipated energy (CDE), torsional amplitude, and endothelial cell density (ECD). Patients and Methods This prospective, randomized study was conducted at Oka Eye Clinic (Fukuoka, Japan). Surgeries were performed using FLACS (with LenSx) or conventional technique in adults ≥20 years with grade 2–4 cataracts. Visits included preoperative, surgery day, and 5 postoperative visits (days 1, 4–10, 20–40, 60–120, and 150–210). Primary endpoint was CDE. Secondary endpoints included ECD percent change at day 150–210 versus preoperative visit and average torsional amplitude on surgery day. Exploratory endpoints included central corneal thickness and corrected distance visual acuity (CDVA). Superiority of FLACS to conventional technique was evaluated using t-tests based on a mixed model for repeated measures. Results Full analysis set included 53 eyes per group. Mean cataract grade was 2.92±0.58 in FLACS and 2.94±0.57 in conventional group. FLACS versus conventional method had significantly lower mean CDE (0.213±0.334 versus 1.718±0.898%-seconds, respectively; P, Video Abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/xzalrupRtlw

BACKGROUND Accurate identification of the cricothyroid membrane is crucial for successful cricothyroidotomy. The aim of this study was to compare the conventional downward and modified upward laryngeal handshake techniques in terms of accuracy to identify the cricothyroid membrane in nonobese female patients. METHODS In 198 anesthetized female patients, the cricothyroid membrane was identified by either the conventional downward laryngeal handshake technique (n = 99) or the modified upward laryngeal handshake technique (n = 99). According to the conventional downward laryngeal handshake technique, the cricothyroid membrane was identified by palpating the neck downward from the greater cornu of the hyoid bone, thyroid laminae, and cricoid cartilage. According to the modified upward laryngeal handshake technique, the cricothyroid membrane was located by moving up from the sternal notch. The primary outcome was the accuracy of identifying the cricothyroid membrane. Secondary outcomes included the accuracy of midline identification and time taken to locate what participants believed to be the cricothyroid membrane. The primary and secondary outcomes according to the technique were analyzed using generalized estimating equations. RESULTS The cricothyroid membrane could be identified more accurately by the modified upward laryngeal handshake technique than by the conventional downward technique (84% vs 56%, respectively; odds ratio [OR], 4.36; 95% confidence interval [CI], 2.13-8.93; P < .001). Identification of the midline was also more accurate by the modified laryngeal handshake than by the conventional technique (96% vs 83%, respectively; OR, 4.98; 95% CI, 1.65-15.01; P = .004). The time taken to identify the cricothyroid membrane was not different between the conventional and modified techniques (20.2 [16.2-26.6] seconds vs 19.0 [14.5-26.4] seconds, respectively; P = .83). CONCLUSIONS The modified upward laryngeal handshake technique that involved tracing the trachea and laryngeal structures upward from the sternal notch was more accurate in identifying the cricothyroid membrane than the conventional downward technique in anesthetized female patients.

Highlights Abstract Background: Obtaining peripheral venous access, especially in children, is usually a challenging procedure for nursing professionals. In pediatric patients this is because of the small caliber of the vessels, deep localization in the tissue, and multiple previous attempts of venipuncture. This experiment compared the success in obtaining venous access in pediatric patients with the use of near-infrared light and with the conventional technique. Method: True experiment, developed in a large private general hospital and a public general hospital under the same management. The study included children aged 0 to 6 y (including newborns and pediatric patients up to 5 y, 11 mo and 29 d) under clinical or surgical treatment, undergoing peripheral venous puncture both for laboratory test collection and for infusion of medications and solutions. A total of 144 punctures were analyzed, 51.4% with the conventional technique and 48.6% using the device with near-infrared light. Results: The success for the conventional technique was 89.2%, and 97.1% on the technique with near-infrared light, P = 0.098, with no evidence of significant differences. Conclusion: The success rate for obtaining peripheral venous access in children was similar in the study groups. This study expands the knowledge about the success in the peripheral venous puncture by considering that this is not exclusively related to the use of supportive technologies.

Background We have proposed a modified, completely intrafascial radical cysprostatectomy (RC) to treat bladder cancer patients with the aim of preserving the patients’ post-surgical urinary control and erectile function. This study aimed to evaluate the oncological and functional outcomes of this innovation relatively to that with the conventional technique. Methods A retrospective, single-center, blinded, and controlled study was conducted using the medical data of patients since the past 5 years from the hospital database. A total of 44 patients were included, including 20 who received complete intrafascial cysprostatectomy and 24 who received conventional interfascial surgeries. The patients’ continent and sexual information of 1-year follow-up after the surgery were extracted. The oncological and functional outcomes of the 2 groups were compared and analyzed. Results The demographics parameters of the 2 groups showed no significant difference. The results of follow-up of the oncological outcomes did not reveal any significant difference between the completely intrafascial group and the conventional interfascial group in terms of the positive surgical margins, local recurrences, and distant metastasis. Patients following neobladder diversion in the intrafascial group showed a faster recovery of the urinary control, with a 76.9% (10/13) daytime continent rate at 3-month, as well as 46.2% (6/13) and 58.3% (7/12) nighttime continent rates at 3-month and 6-month, respectively. Regarding the sexual functions, our results revealed significant advantages in favor of completely intrafascial technique on the post-surgical International Index of Erectile Function (IIEF)-5 score at 3-, 9-, and 12-month follow-up relative to that with the conventional interfascial process. Thus, the IIEF score of patients in the intrafascial group was 11.4 ± 3.5 at 3-month, 14.1 ± 3.6 at 9-month, and 15.2 ± 3.8 at 12-month follow-up after the cystectomy, which was significantly greater than that of the patients in the control group. Conclusions Our novel data illustrated that the modified completely intrafascial technique could result in a better sexual function and faster continence recovery for patients following RC, without any compromise in the cancer control. Thus, this technique could be considered as an alternative extirpative technique for bladder cancer treatment in a clinical setting.

Purpose: To compare between laser and conventional cavity preparation techniques in children, to assess clinical presentation of bulk fill composite and high viscous glass ionomer restoration. Materials and Method: In vivo study included 20 children aged from 4-8 years using split mouth technique (a total of 40 teeth was treated). Group I: 20 teeth treated by turbine. Group II: 20 teeth treated with laser. Each group was subdivided into two subgroups. The teeth were filled with Equia forte in groups IA and IIA or filled with REVEAL HD Bulk composite in groups IB and IIB. Results: Results of the study showed that conventional technique need less time than Laser. It also showed higher mean pain score than Laser although it was not significant. Tooth materials displayed excellent clinical evaluation. Conclusion: laser minimize the onset of pain during caries removal compared with drilling. A longer treatment time was the main disadvantage of this technique. Equia, and bulk fill composite, showed acceptable clinical performance.

INTRODUCTION: To investigate the efficacy of Ultrasonic Bone Scalpel (UBS) in thoracic spinal stenosis (TSS) in comparison to traditional technique. MATERIALS AND METHODS: A total of 55 patients who had undergone conventional surgery (Group A) are compared with 45 patients of UBS (Group B) in TSS. The primary outcome measure of Modified Japanese Orthopaedic Association score (m JOA) with neurological complications and dural injury were assessed. Secondary outcome measures of total blood loss (TBL), time duration of surgery (ORT) and length of hospital stay (LHS) were analysed. Results: The pre-operative mJOA score 5.00(4.00-6.00) in the group A and 5.00(4.00-6.00) in the group B improved to 7.00(7.00-8.00) in the group A and 9.00(9.00-10.00) in the group B, respectively (P

Background: The aim of the study was to demonstrate the technique of total laparoscopic hysterectomy (TLH) with intra-corporeal endosuturing using simple sutures and basic surgical instruments and compare with TLH using electric coagulation equipment i.e. energy sources with regard to operative time, blood loss, postoperative stay and pain scores. Methods: A retrospective study was undertaken, in Max Super Specialty Hospital Saket, from June 2015 to May 2018, which included 586 cases of TLH (for benign gynecological conditions), of which 287 were performed using intra-corporeal endosuturing (Group 1) and 299 were performed using energy sources (Group 2). To avoid bias, baseline matching was done for body mass index (BMI), indications for surgery, size of uterus, previous abdominal surgeries and comorbidities like diabetes and hypertension after which there were 172 patients in each group. Results: The mean age of patients was 48.24 ± 6.76 years. All operative outcomes including operative time (104.1 ± 22.6 vs 107.6 ± 32.6 mins, p=0.25), blood loss (78.9 ± 101.6 vs 99.7 ± 177.6 ml, p=0.19), pain score (2.5 ± 1.3 vs 2.7 ± 1.2, p=0.13) and post-operative stay (2.05 ± 0.2 vs 2.07 ± 0.3 days, p=0.36) were similar between the two groups. Uterine size was the major determinant of operative time and operative blood loss. Conclusion: TLH with intracorporeal endosuturing can be performed safely and gives results comparable with TLH performed using energy sources. Advancement in suturing devices can decrease operative time further and potentially make it easier and more acceptable.

Background Ridge splitting technique is considered one of the successful horizontal bone augmentation procedures especially for the maxillary bone, the aim of this study was to compare marginal bone loss using a novel ridge splitting protocol versus the conventional technique. Material & methods This was a randomized clinical trial including 20 patients who were randomly assigned to ridge splitting with simultaneous implant placement at the anterior maxillary aesthetic zone (10 patients, 29 dental implant) using patient specific guides (PSGs) or conventional technique (10 patients, 29 dental implant). In the control group free hand ridge splitting was done, while in the study group all the splitting and drilling procedures were done through specific slits and sleeves at the patient specific guides. Radiographic Assessment included measurements of linear changes in the vertical dimensions of the labial plate of bone on cross sectional cuts of computed tomography (CBCT) using mimics software. Results Wound healing was uneventful for all the patients except one patient in the control group that showed bad split and another showed buccal fenestration. The study group showed lower bone loss (1.38 ± 0.61 mm) compared to the control group (2.42 ± 0.63 mm), with statistical significance difference (P value = 0.001). The loss percentage also was higher in the study group (10.99 ± 4.76%) compared to the control group (19.12 ± 4.53%), and there was statistical significance difference between the two groups (P value = 0.001). Conclusion Ridge splitting using PSGs appear to be efficient and promising than the free hand technique.

Background: Arterial puncture, for obtaining an analysis of blood gas, is an interventional procedure often performed in emergency departments and intensive care units. This study compares the ultrasound (US) guided method with the conventional digital palpation method in radial artery puncture (RAP) for blood gas analysis in septic shock patients. Methods: This is a prospective, single-centre study. Septic shock patients over 18 years of age who needed a RAP sample for blood gas analysis were included. Patients with local infection or trauma at the puncture site, arteriovenous fistula, vascular graft, coagulopathy, a positive Allen test, or did not want to participate were excluded. Patients were randomized into two groups and RAP was obtained with either the US-guided method or the conventional method. The main outcomes were success at first entry, the number of attempts before success, and the time to success. Results: The 50 eligible patients were randomized into two groups. First entry success rate for the US-guided group and the conventional group was 80% and 42%, respectively. The number of attempts before success and time to success was significantly higher in the conventional group. Conclusion: The US-guided method has been found to be more successful in terms of first entry success, the number of attempts before success, and the time to success when compared to the conventional method.

Purpose: The treatment of hepatic neoplasms has undergone, in recent years, various evolution of the surgical technique and extension to the indication for resection. Many patients with liver tumors cannot benefit from resection due to the difficulty of the anatomical site of the lesion.Of these patients, only some can benefit from ex vivo hepatic resection, which consists of a complete hepatectomy, bench tumor resection and self-transplant. Materials and methods: We have retrospectively evaluated PUBMED databases. Studies was evaluated from 2010 to 2020.Only very few studies analyzed “Ex situ liver resection”, “Extracorporeal liver resection”, “Liver auto-transplantation”. Conclusion: Ex vivo liver resection and autotransplantation is fesible in very few patients with unresectable hepatic tumor fit for surgery. R0 resection accounts about 60%-90% but outcomes are less satisfactory due to high complications rate of about 25% and low survival in 3 years.

To compare the efficacy, acceptance and preference of conventional infiltration technique with a needleless jet anaesthetic device (Comfort-In). Non-fearful healthy adult volunteers, aged 19–40 years, were recruited in the Dental School of Aristotle University of Thessaloniki, Greece. Intact maxillary premolars were selected for local anaesthesia. Both techniques were applied sequentially with 35 min time gap on either buccal side on the same day by the same operator. The quadrant and the order of administration were randomly assigned using an online randomization generator. Immediately after administration, at 1, 3, 5, 10, 15, 20, 25 and 30 min, pulp vitality and soft tissue pain reaction tests were performed. Each participant was asked 6 questions in order to assess acceptance. At the end of the session, at 24 h and 7 days, all participants were asked to report any adverse events and their preference. In 63 volunteers who were successfully followed, 63 teeth received conventional local infiltration and 63 the Comfort-In. Both techniques presented with similar anaesthetic efficacy at 1, 3, 5, 10 and 15 min, whereas the conventional technique was more efficacious at 20 min (p < 0.005). Both presented similar acceptance apart from higher pain/discomfort during administration of Comfort-In (p = 0.002). Significantly higher preference was reported for the conventional technique immediately after the session, at 24 h and at 7 days (p < 0.0005); 19 (30.2%) reported the presence of ecchymosis or lacerations at the Comfort-In site as opposed to 5 (7.9%) with the conventional method (p < 0.0001). Both techniques showed similar effectiveness. Conventional infiltration was preferred to needleless anaesthesia by non-fearful adult volunteers and was associated with less adverse events. This study enhances the advantages of conventional local anaesthesia. ISRCTN17400733

To evaluate the efficacy of laser-assisted flapless corticotomy in the acceleration of canine retraction compared with the conventional technique and to evaluate patients’ pain and discomfort levels after corticotomy. A single-center randomized controlled trial was conducted on 18 class II division 1 patients (7 males, 11 females; age range: 16 to 24 years) who required the first-upper-premolar extraction followed by canine retraction. A split-mouth design was used in which the Er:YAG laser-assisted flapless corticotomy was randomly allocated to one side, whereas the other side served as the control side. The primary outcome measure was the canine retraction rate which was assessed immediately after laser application, 1, 2, 4, 8, and 12 weeks after laser application. Also, the levels of pain and discomfort during the first week following laser application were assessed. Paired t-tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences. All of the selected eighteen patients entered the statistical analysis stage. Significant differences were observed (P

In the attempt to improve the cosmetic and functional outcomes in head and neck surgeries, robotic or video-assisted neck dissection using remote access has gained ground in recent years. Retroauricular approach emerged as the most versatile option, allowing proper dissection at all neck levels. In this technique, after retroauricular incision, a skin flap is elevated and a self-retaining retractor is placed, creating working space for the robotic, or endoscopic neck dissection. Numerous published series have shown the safety and favorable outcomes of retroauricular robotic neck dissections, without any major complications or surgery-related deaths. The only consistently reported disadvantage is a longer operative time. Our group has an experience of 190 retroauricular neck dissections performed over the last 5 years, without any major setbacks. The oncologic and safety outcomes have been comparable to the conventional technique, with clearly superior aesthetic results. In the process of expansion of Robotic Surgery in Brazil, our center is currently providing training and proctoring to capacitate other head and neck surgeons, and enable other centers to offer this surgical modality.

To compare the reliability of microkeratome dissection with the anterior chamber pressurizer (ACP) system versus conventional pressurization for ultrathin Descemet-stripping automated endothelial keratoplasty (UT-DSAEK) graft preparation.A retrospective review of a consecutive series of dissected donor corneas processed at Pavia Eye Bank for UT-DSAEK surgery was performed. Grafts were prepared through single-pass microkeratome dissection with artificial anterior chamber internal pressure regulation through either ACP or the conventional method using a water column with tube clamp. The target central graft thickness (CGT) was ≤100 μm. Cutting predictability was determined as the difference between the microkeratome head size and the thickness actually removed. Graft regularity was investigated as central-to-peripheral thickness increase, central-to-peripheral (CP) ratio, and graft thickness uniformity. Thickness was measured with anterior segment optical coherence tomography (horizontal and vertical meridians).Of the 265 UT-DSAEK grafts, ACP achieved the target "CGT ≤ 100 μm" in 87 of 120 (72.5%), whereas the conventional technique achieved the same in 85 of 145 (58.6%) (P = 0.018). ACP predictability was -3.9 μm (SD: 2.3), whereas predictability of the conventional technique was -54.6 μm (SD: 3.7) (P0.001). Thickness increased similarly (P = 0.212); CP ratio was better with ACP for only 2 mm diameter (P = 0.001); graft thickness uniformity was comparable (P0.05).Compared with conventional pressurization, ACP improved microkeratome-assisted preparation reliability of UT-DSAEK grafts, achieving CGT ≤ 100 μm with significantly higher frequency (P = 0.018) and predictability (P0.001). ACP improved CP ratio only at 2 mm (P = 0.001); for other graft thickness, the 2 methods proved equivalent.

Conventional technique for transcutaneous bone-anchored hearing implants surgery requires the elevation of a large retroauricular skin flap to expose the site of implantation, that may cause a large scar and the interruption of retroauricular vasculature. A less invasive, endoscopic-assisted modification of the surgical technique is described, which provides access to the implant site through two small skin incisions and the creation of a pocket in the retroauricular area. Endoscopic-assisted bone-anchored hearing implant surgery could be a viable option for transcutaneous bone-anchored hearing implant surgery, especially for pediatric patients.

Introduction This study evaluated the success rate of and tooth substance removal required for computer-guided preparation of endodontic access cavities. Methods Thirty acrylic typodont teeth with root canals (10 each of tooth numbers 11, 14, and 17) were randomly allocated to a study or control group (15 teeth per group). In the study group, teeth were fixed in acrylic resin and subsequently digitized using a laboratory scanner. A cone-beam computed tomographic scan was then taken. Access cavity preparations were planned virtually, and a template was 3-dimensionally printed. In the control group, access cavities were prepared using the conventional access technique. Tooth substance removal was assessed by weighing teeth before and after preparation. Volume loss was analyzed statistically by use of the Wilcoxon-Mann-Whitney test at a significance level of P Results Using guided endodontics, 93.3% of root canals were located successfully compared with 100% of root canals using the conventional technique. In the control group, the mean tooth substance removal was 16.1 ± 3.7 mm³ for incisors, 44.2 ± 8.9 mm³ for premolars, and 99.3 ± 3.1 mm³ for molars. In the study group, significantly less tooth substance was removed; substance loss was 10.3 ± 1.1 mm³ for incisors, 29.3 ± 4.2 mm³ for premolars, and 51.8 ± 5.3 mm³ for molars. Conclusions The use of guided endodontics in normally calcified teeth enables the preservation of a significant amount of tooth substance. However, this advantage must be carefully balanced against a greater radiation burden and risk of perforation, higher costs, and more difficult debridement and visualization of the pulp chamber and root canals.

Background: Thyroid gland is a highly vascular organ. So, doing thyroidectomy requires good hemostasis even for the small blood vessels either through conventional tie technique which is time-consuming or through the use of a harmonic scalpel. Objective: To evaluate the real benefits of the Harmonic Scalpel in total thyroidectomies when compared with conventional ligation, in terms of operative time, postoperative drainage, and complications. Patients and methods: This randomized, prospective observational study was carried out at Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt. Written informed consents were obtained from Seventy-six patients with benign goiter disorders who were scheduled for elective total thyroidectomy during a period from August 2019 to October 2020. Thirty eight patients were submitted to conventional thyroidectomy (group A), and thirty eight underwent thyroidectomy using a harmonic scalpel (group B). Results: There was no statistical difference between the two groups as regards demographic data, hospital stay, recurrent laryngeal nerve injury, and hypocalcemia, but there was a statistically significant difference as regards operative time (76.9±15.1 min in group A versus 89.23±17.68 in group B) and drainage volume (111.75±56.57 mls in group A versus 89 ± 16.21 mls in group B). Conclusion: Harmonic scalpel for total thyroidectomy is a better choice compared to the conventional tie technique as regards operative time and postoperative drainage volume.

Objective: It is irrefutable that the extraction of teeth inextricably results in definitive changes in the surrounding hard and soft tissues. Recently, Socket-Shield Technique (SST) has been used to keep the buccal two-third of the root intact in the socket. This buccal shield further preserves the periodontium-bundle bone complex and hence preserves the buccal hard and soft tissue. The purpose of the study was to do a statistical comparative analysis of two different types of flapless and graftless techniques using the esthetic (Pink Esthetic Index) and radiological parameters. Materials and Methods: A total of thirty nonrestorable tooth/root stumps (vital or nonvital) were selected and randomly allocated to two different groups: control group with immediate conventional implant placement (without SST) (Group C, n = 15) and test group with immediate implant placement using SST (Group S, n = 15). All of the sites received immediate chairside temporaries. All implants were restored either with screw- or cement-retained prostheses 4 months postoperative. Each control and test group was analyzed at two different durations: 15 days after placement of provisional and 15 days after placement of definitive prosthesis. Five parameters of Pink Esthetic Score (PES) were used for esthetic analysis, and digital periapical radiographs were used for radiographic analysis. Results: Within the time frame of the study (15 days postplacement of definitive prosthesis), a statistically significant difference (p < 0.05) was observed between PES of the two techniques. Test group S (mean = 9.07) showed better scores than control group C (mean = 6.87). It was observed that buccal bone was maintained in all the cases of test group S while there was loss of buccal bone in almost all the cases of control group C. Conclusion: Within the limitations of this short-term pilot study, better soft-tissue parameters were observed with SST as compared to a conventional graftless technique whenever a restoration on immediate implant placement is considered.

Although conventional (Halsted) inferior alveolar nerve block is the most applied nerve block in Dentistry, it is still the most frustrating with high failure rates up to13% or even higher due to inconsistent intraoral landmarks. So, the current study aims at comparing a novel technique for the inferior alveolar nerve block (IANB) depending on extraoral landmarks with the conventional technique. The study group patients received IANB employing the novel technique. The novel technique depended entirely on extraoral consistent landmarks which were the base of the columella, the outer canthus of the right and the left eye, and the upper lip. In the control group, the conventional technique was applied. The success rate and the onset, the duration, and the depth of anaesthesia were assessed. Complications were recorded. While the novel technique achieved higher success rate (98.68%) than the conventional technique (88.16%), the differences with regards with all other parameters to assess the local anaesthesia were statistically insignificant. The novel technique provides the clinicians with a new tool that might be a reliable substitute for the conventional technique since the former depends entirely on extraoral consistent landmarks, which also might account for its simplicity, accuracy, and high success rate.

Objectives: The aim of this study is to evaluate the applicability and feasibility of Colpotomizer-assisted total abdominal hysterectomy (CATAH), a new technique for uterine removal in benign uterine pathologies. Materials and Methods: This study is a prospective cohort study conducted at a tertiary University hospital in Egypt. Eligible patients (n = 88) for total abdominal hysterectomy (TAH) were divided into two groups; the study group who underwent TAH by the CATAH technique and the control group who underwent TAH by the conventional technique. Demographic data, operative time, blood loss, and operative complications were recorded. Results: The mean operative time was significantly reduced (64.47 ± 3.60 min) in the study group than in the control group (86.42 ± 5.54 min, P < 0.001). The mean time for cervical removal was significantly less (8.60 ± 1.39 min) in the study group than (17.77 ± 2.62 min) in the control group (P < 0.001). The mean volume of blood loss was less (197.38 ± 39.42 ml) in the study group than in the control group (462.69 ± 167.96 ml). Complications were fewer in the study group than in the control group. Conclusion: The CATAH technique was feasible, quicker with less intraoperative and postoperative complications than the conventional technique for TAH in benign uterine pathologies.

Introduction: Percutaneous thermal ablation is widely adopted as a curative treatment approach for unresectable liver neoplasms. Accurate immediate assessment of therapeutic response post-ablation is critical to achieve favourable outcomes. The conventional technique of side-by-side comparison of pre- and post-ablation scans is challenging and hence there is a need for improved methods, which will accurately evaluate the immediate post-therapeutic response. Objectives and Significance: This review summarizes the findings of studies investigating the feasibility and efficacy of the fusion imaging systems in the immediate post-operative assessment of the therapeutic response to thermal ablation in liver neoplasms. The findings could potentially empower the clinicians with updated knowledge of the state-of-the-art in the assessment of treatment response for unresectable liver neoplasms. Methods and Analysis: A rapid review will be performed on publicly available major electronic databases to identify articles reporting the feasibility and efficacy of the fusion imaging systems in the immediate assessment of the therapeutic response to thermal ablation in liver neoplasms. The risk of bias and quality of articles will be assessed using the Cochrane risk of bias tool 2.0 and Newcastle Ottawa tool. Ethics and Dissemination: Being a review, we do not anticipate the need for any approval from the Institutional Review Board. The outcomes of this study will be published in a peer-reviewed journal. Highlights Evaluation of the therapeutic response in liver neoplasms immediately post-ablation is critical to achieve favourable patient outcomes. We will examine the feasibility and technical efficacy of different fusion imaging systems in assessing the immediate treatment response post-ablation. The findings are expected to guide the clinicians with updated knowledge on the state-of-the-art when assessing the immediate treatment response for unresectable liver neoplasms.

Introduction Computed tomography (CT)-guided vertebral biopsy is always recommended for histopathological and microbiological confirmation in cases of tuberculous spondylodiscitis and for antimycobacterial drug sensitivity testing. Aim To compare the conventional technique and a novel axis-defined tram-track technique of CT-guided vertebral biopsy in suspected tuberculous spondylodiscitis. Materials and Methods Sixty-seven patients of clinico-radiologically suspected tuberculous spondylodiscitis referred for CT-guided vertebral biopsy were categorized into two groups: “Group A” patients (n = 32) underwent biopsy by conventional technique, and “Group B” patients (n = 35) by axis-defined tram-track technique. The time taken for procedure, radiation exposure, and any procedural complications were recorded for both the groups. Results A statistically significant difference in procedure time and mean radiation dose was observed between the two groups: a longer procedural time was required in “Group A” (52.5 ± 3.5 minutes) as compared to “Group B” (37.3 ± 3.6 minutes) (p < 0.0001); and mean radiation dose (CTDIvol) in “Group A” and “Group B” was 8.64 ± 1.06 mGy and 5.73 ± 0.71 mGy, respectively (p < 0.0001). However, the difference in complication rate and tissue yield for successful diagnosis of the biopsies in the two groups was found to be statistically insignificant. Conclusion Axis-defined tram-track technique was found to have a significantly shorter procedural time as well as lower radiation exposure compared to the conventional technique of vertebral biopsy in our study.

Purpose To compare joint line restoration after unicompartmental knee arthroplasty (UKA) between conventional and robotic-assisted surgery. Previous studies have shown that joint line distalization can lead to higher failure rates. The hypothesis was that robotic-assisted UKA is associated with less femoral component distalization and a precise tibial cut, which allows a more anatomical restitution of the knee joint line. Methods Retrospective cohort study of patients undergoing medial or lateral UKA between May 2018 and March 2020. Preoperative and postoperative radiologic assessment of the joint line was performed by two observers, using three different methods, one for tibial slope and one for tibial resection. Robotic assisted UKA and conventional UKA groups were compared. Results Sixty UKA were included, of which 48 (77.42%) were medial. Robotic-assisted UKA were 40 (64.52%) and 22(35.48%) were conventional The distalization of the femoral component was higher in the conventional group despite the method of measurement used In both Weber methods, the difference was statistically different: Conventional 2.3 (0.9 to 5.6) v/s Robotic 1.5 (− 1.1 to 4.1) (p =0.0025*). A higher proportion of patients achieved a femoral component position ≤ two millimeters from the joint line using robotic-assisted UKA compared to the conventional technique . No statistical difference between robotic-assisted and conventional UKA was found in tibial resection and slope. Conclusion Robotic-assisted UKA shows a better rate of joint line restoration due to less femoral component distalization than conventional UKA. No difference was found in the amount of tibial resection between groups in this study. Level of evidence III

Introduction: Nasal septal deviation is a condition which is frequently encountered in the general population. Surgical correction of this problem has been the mainstay of treatment for over a century. This study is to compare SMR with Single sided mucoperichondral resection. This new technique in Septal Surgery is found without complication whereas complications were noted in SMR. Materials and Methods: The study to compare the Single sided mucoperichondrial resection versus conventional SMR was carried out in the Department of Otorhinolaryngology at AJ Institute of Medical Sciences and Research Centre, Mangalore, Karnataka during the period from 1st October 2018 to 31st September 2019. A total of 20 cases with symptomatic DNS were included in the study, after randomization 10 cases underwent conventional SMR and 10 cases Single sided mucoperichondrial resection. Results: Among 10 patients who underwent conventional SMR, Septal hematoma and septal perforation were the most common complications. None of the patients who underwent Single sided mucoperichondrial resection had any complications. Conclusion: In conventional SMR, retention of both mucoperichondrial flaps results in many recognized post op complications. In Single sided mucoperichondrial resection, no complications were seen in comparison. Keywords: Nasal septum, SMR, Single sided mucoperichondrial resection, Septal hematoma.

Background: Several comparative studies are reported in Literature to define a standard for ideal treatment of hemorrhoidal disease. Radical surgery is the only therapeutic option in case of III and IV stage haemorrhoids. Hemorrhoids surgical techniques are classified as Open, Closed and Stapled ones. This study was done to compare the postoperative recovery and complications of PPH and conventional MMH. Materials & Methods: 30 patients with haemorrhoids were managed with surgical ligation and excision of haemorrhoids i.e. by the Milligan-Morgan technique (Group I) and the remaining 30 were managed with stapled haemorrhoidectomy, which was performed by Longo’s technique (Group II). Postoperatively, the patients were properly assessed for the degree of pain according to VAS pain scale, number of analgesics consumed, any urinary retention, first bowel action postoperatively, any haemorrhage or urinary or faecal incontinence. Results: The maximum number of patients were seen in the age group 30-40 years i.e. 18 (30%), of which 14 (23.33%) were male and 4 (6.66%) were female. Analgesics required during hospitalization was 12.33 in group I and 4 in group II, acute urine retention was seen in 8 in group I and 4 in group II, pain (vas) on day 1 was 8.6 in group I and 6.6 in group II, D2 was 6.8 in group I and 3.2 in group III and on day 3 was 5.5 in group I and 2.6 in group II. Hospital stay was 4.37 days in group I and 1.9 days in group II. Post- operative complications was reactionary haemorrhage 2 in group I, secondary haemorrhage 1 in group I and faecal Incontinence 2 in group I and 1 in group II. The difference was significant (P< 0.05). Stapler technique has significantly less requirement of analgesics on day 21, 6 weeks and 3 months compared to conventional technique. More satisfaction in the stapled haemorrhoidectomy group patients indicates that the merits of the stapled technique outweigh those of the conventional technique. Conclusion: Authors found stapled haemorrhoidectomy make it a better technique than the conventional haemorrhoidectomy for managing grade II and grade III hemorrhoids such as lesser operating time, postoperative pain, analgesics required, complications like postoperative urinary retention, postoperative hemorrhage and urinary or faecal incontinence.

Background There are several systematic reviews of multiple implant loading techniques, but results are conflicting. Aim To perform an umbrella review on methodological quality of systematic reviews about techniques for loading multiple dental implants. Material and methods MEDLINE (PubMed) and Scopus were searched up to December 31, 2019. Unpublished literature was searched through OpenGray and references of included articles were manually verified. Eligibility criteria were: articles had to (1) be about multiple dental implants; (2) mention the moment of loading; (3) be a systematic review. Two independent reviewers participated in the entire process. Qualitative description of included studies as well as methodological quality measurement and risk of bias through AMSTAR and ROBIS were performed. Results 21 reviews were included. Thirteen stated that there was a similarity between loading techniques, two did not affirm which one was more appropriate and six mentioned that conventional technique was better. Eight papers were classified as high risk of bias, twelve as low and one as uncertain risk. Conclusion When evaluating only studies with a low risk of bias, there are no significant differences in implant loading time.

Purpose: The purpose of this study was to access post-operative clinical as well as radioghraphic success of Diode Laser / Mineral Trioxide Aggregate (MTA) and Diode Laser /Biodentine (BD) pulpotomy procedures in comparison to conventional technique using Formocresol /Zinc Oxide Eugenol (FC/ZOE) pulpotomy for human primary molars. Materials and Methods: A total of 90 lower primary molars that had deep carious lesion and need pulpotomy treatment from 66 healthy and cooperative patients, aged 4-6 years old were chosen for this study. After removal of the coronal tissue and depending on the type of radicular pulp medicament, the teeth were divided randomly and equally into three groups; Group A (FC/ZOE), Group B (Diode Laser/MTA) and Group C (Diode laser/BD). Treatments in all groups were completed with Glass Ionommer restoration then stainless steel crowns. Results: The cumulative clinical and radiographic success rates after 12 months follow up were 90.3%, 96.3% and 100% for the FC/ZOE, Diode Laser/MTA and Diode Laser/BD pulpotomy groups respectively. Conclusion: Laser assessed pulpotomy in combination with MTA or Biodentine had a more advanced clinical and radiographic success rate correlated to FC/ZOE pulpotomy technique in primary molar. Statistically, no significance difference was found between the three study groups in the overall clinical and radiographic success rate.

International audience; Fish oocyte development monitoring is a mandatory operation when studying breeding in captivity as well as in the wild. In aquaculture, it is required to determine the best fertilization time. In the wild, it helps to detect spawning grounds, the distribution of fish species and the interaction between animals and their environment. In both settings, the conventional technique for developmental stage identification consists of handling the fish for oocyte sampling and sample observation using a binocular zoom head. Such an operation is difficult for the operator as well as for the fish. There is a need for repeated anesthesia and oocyte sampling, and it relies on operator expertise to identify the developmental stage. In this context, this publication proposes, for the first time, to study the potential of bioimpedance measurement as an alternative in fish breeding studies. We have set up an experiment combining the in vitro bioimpedance measurement of sampled oocytes with the conventional estimation technique for 69 sampled collected on farmed European sea bass. The statistical analysis has demonstrated that three of the four main developmental stages can be identified using bioimpedance measurement. The integrability of the bioimpedance technique with its implantable sensor makes this potential alternative approach very promising. Thanks to this sensor it could be possible, for the first time ever, to monitor in vivo the oocyte developmental stage in captivity as well as in the wild.

Aim:Ketamine administration in high dosage leads to certain adverse reactions. This study aimed to evaluate the effect of low-dose intravenous ketamine bolus versus conventional injection for the reduction of upper and lower extremity fractures in children.Materials and Methods:A total of 198 paediatric patients with extremity fractures were enrolled. They were randomly categorized into two groups. In the intervention group, a number of 100 patients participated with a mean age of 8.89±4.37, among them 77 (77%) were male and upper limb fractures were more common (84%). They were assigned to receive 1% ketamine at a dose of 0.5 mg/kg (within 5 s), and in the control group, a number of 98 patients participated with a mean age of 9.08±3.98, among them 73 (74.5%) were male and upper limb fractures were more common (83.7%). They received ketamine at 1.5 mg/kg for 30-60 s. The outcomes were measured, and the satisfaction of patients and physicians was recorded.Results:Successful sedation rate was significantly lower in the low-dose ketamine group than in the control group (7% vs 100%; p

Background: Zimmer iASSIST knee is an accelerometer-based navigation system with the aim of achieving better alignment in total knee arthroplasty (TKA). We have started using this system since early 2016. This is a retrospective case–control study, which aims to compare the radiological alignment, operation time, and blood loss of TKAs performed using the iASSIST system and those using conventional techniques. Materials and Methods: 42 TKAs using Zimmer iASSIST and 44 TKAs using conventional instrumentation were recruited. The overall coronal alignment and the coronal and sagittal alignment of the femoral and tibial component were compared. For coronal alignment, additional analysis of the absolute deviation from neutral mechanical axis was performed to avoid canceling out of varus/valgus deviation. The number of outliers, operation time, and blood loss in terms of maximal hemoglobin drop were also compared. Results: When comparing the alignment of the iASSIST group with the conventional group, there were no significant differences ( p > 0.05) in the number of outliers, mean coronal alignments, mean deviation from neutral coronal mechanical axis (2.9° vs. 2.9°), and femoral component flexion angle (4.9° vs. 4.7°). The difference in the mean tibial component posterior slope was significant (5.7° vs. 7.1°, p < 0.05). The mean operation time was significantly longer by 13 min ( p < 0.05) in the iASSIST group. There were no significant differences in the mean hemoglobin drop between the two groups. Conclusion: The results demonstrated no significant differences in terms of coronal radiological alignment, femoral flexion angle, outliers, and blood loss between iASSIST and conventional technique. There was a small but statistically significant difference in tibial posterior slope. The iASSIST group needed a longer operation time.

Importance: Using asymmetric dorsal preservation (ADP) (pushdown technique for deviated side and letdown technique to the contralateral nondeviated side) is an alternative surgical method to correc...

3D direct planimetry is increasingly used in clinical practice as a rapid way to measure the mitral valve area (MVA) in patients with rheumatic mitral stenosis (MS) who underwent three-dimensional transesophageal echocardiography (3D-TEE). However, data on its accuracy and reliability are scarce. This study aimed to compare the MVA measurements obtained by 3D direct planimetry to the conventional technique multiplanar reconstruction (MPR) in MS patients using 3D-TEE. We retrospectively included 49 patients with rheumatic MS undergoing clinically-indicated 3D-TEE in the study. We determined the 3D direct planimetry measurements of MVA from the left atria aspect (MVALA) and the left ventricle aspect (MVALV), and compared those with the MPR method (MVAMPR). We also assessed the major and minor diameters of the mitral valve orifice using MPR and 3D direct planimetry. We found an excellent agreement between the MVA measurements obtained by the MPR method and 3D direct planimetry (MVALA and MVALV) [intraclass correlation coefficients (ICC) = 0.951 and 0.950, respectively]. However, the MVAMPR measurements were significantly larger than the MVALA and MVALV (p

BACKGROUND: Anatomical placement of an ACL graft is critical to the clinical outcome of an ACL reconstruction. The purpose of the study was to compare the conventional technique of drilling a femoral tunnel from a medial portal while viewing it from a lateral portal versus viewing it from a high anteromedial portal and drilling it from a low medial portal. We hypothesized that the high anteromedial portal possibly provides an end-on view of the tunnel and would lead to a more favourable tunnel position. MATERIALS AND METHODS: Sixty patients underwent arthroscopic single-bundle ACL reconstruction with a soft tissue graft. All patients had the same surgeon and same surgical technique (except viewing portal). Each patient underwent a 3D-CT 1-week post-op. We classified the patients into two groups (technique A and B) of 30 each. Postoperative tunnel position in each patient was visualized on CT scan with 3D reconstruction by the quadrant method described by Bernard et al. The distance of the centre of the femoral tunnel from the superior and posterior border of the Bernard frame was obtained in each patient of the two groups and mean value in each group was obtained and compared by Student ‘t’ test at 5% level of significance. The position of the femoral tunnels was also studied in reference to the lateral intercondylar ridge and classified into type I (well placed), type II (moderately malpositioned) and type III (grossly malpositioned) RESULTS: The mean distances in technique A from the posterior and superior border of the lateral femoral condyle was 35.8 ± 8.2 and 35.2 ± 6.7, and in technique B was 38.1 ± 8.6 and 35.8 ± 9.4. The two groups did not differ significantly (P > 0.05) in femoral tunnel position as visualized on 3D-CT scan postoperatively. 53.3% patients had well-placed tunnels (type I) overall with 56.67% of technique A and 50% of technique B in this group. None of the tunnels were grossly malpositioned. CONCLUSIONS: The absence of any statistically significant difference between the groups suggests that a high anterolateral portal close to the patellar tendon gives an almost complete view of the lateral aspect of the notch, if not end on. Both techniques produced a majority of well placed (type I) tunnels

Background: Frenum that encroaches on the margin of the gingiva may interfere with plaque removal and can lead to gingival recession and midline diastema. Thus, to maintain proper oral hygiene and prevent gingival recession, frenectomy is done. Frenectomy can be accomplished by conventional frenectomy technique, which has certain disadvantages. To overcome those drawbacks, paralleling technique of frenectomy has been introduced. Both the techniques can be performed by using various treatment modalities. Aim: The purpose of this clinical study was to compare the bleeding during surgery, post-operative wound healing and patient's perception towards the conventional frenectomy technique with scalpel, paralleling frenectomy technique with scalpel and paralleling technique with electrocautery. Materials and method: A total of 30 subjects with gingival or papillary frenal attachment were selected and equally divided into three groups. Group 1 was treated by conventional technique with scalpel, Group 2 by paralleling technique with scalpel and Group 3 by paralleling technique with electrocautery. Various parameters such as bleeding during surgery, patient's perception towards the various techniques and post-operative wound healing were evaluated. Results: The results showed that bleeding during surgery was minimum in group 3 as compared to other two groups. Patient's perception towards paralleling technique with scalpel, was found better than the other groups. At 7th day, though there was a difference in the healing but at 21st day wound healing was almost similar in all the three groups. Conclusion: Based on our findings and clinical outcome, paralleling technique with scalpel provided better patient's perception and an efficient and satisfactory option for frenectomy.

The purpose of this study was to verify the applicability of the compressive radiographic technique (pressures of 5, 10, 15 and 20mmHg) in the diagnosis of tracheal collapse in small breed dogs, in lateral cervicothoracic radiography. Out of the 50 dogs evaluated, 25 presented tracheal collapse (TG group), 23 did not present tracheal collapse (CG) and two were excluded because they did not tolerate a pressure of 20 mmHg. The TG group presented a smaller internal diameter of the trachea in the region of the fourth cervical vertebra (D4) and at the entrance of the thorax (TDE) compared to the CG group, in all the radiographic projections performed, as well as within the TG group where the compressive technique differed from conventional. Furthermore, there was a correlation between the clinical sign of coughing during cervical collar use and the presence of radiographic tracheal collapse at a pressure of 20 mmHg. It was concluded that the compressive radiographic technique was feasible and efficient in confirming the diagnosis of tracheal collapse in dogs, especially in the pressure of 20 mmHg, where it was associated with clinical signs, and can be used in isolation or complementary to the conventional technique. RESUMO O objetivo deste trabalho foi verificar a aplicabilidade da técnica radiográfica compressiva no diagnóstico do colapso de traqueia em cães de raças pequenas, por meio da comparação do diâmetro da traqueia durante a radiografia cervicotorácica lateral convencional e sobre influência da compressão externa com pressões de 5, 10, 15 e 20mmHg (técnica compressiva). Dos 50 cães avaliados, 25 apresentaram colapso de traqueia (grupo TG), 23 não apresentaram o colabamento traqueal (grupo controle - CG) e dois foram excluídos por não tolerarem a pressão de 20mmHg. Os diâmetros internos da traqueia na região da quarta vértebra cervical (D4) e na entrada do tórax (DET) foram menores no grupo TG em relação ao CG, em todas as projeções radiográficas realizadas, bem como dentro do grupo TG, no qual a técnica compressiva diferiu da convencional. Houve correlação entre o sinal clínico de tosse durante o uso de coleira cervical e a presença do colapso de traqueia radiográfico, na pressão de 20mmHg. Concluiu-se que a técnica radiográfica compressiva foi exequível e eficiente na confirmação do diagnóstico do colapso de traqueia em cães, especialmente na pressão de 20mmHg, em que houve associação com sinais clínicos, podendo ser utilizada de forma isolada ou complementar à técnica convencional.

Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy of a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed to evaluate the diagnostic yield of MOSE compared with conventional EUS-FNTA without rapid on-site evaluation (ROSE).Methods This was an international, multicenter, prospective, randomized controlled study. After providing informed consent, consecutive adult patients referred for EUS-FNTA for solid lesions larger than 2 cm were randomized to a MOSE arm or to a conventional arm without ROSE. A designated cytopathologist from each center performed all cytopathological examinations for that center and was blinded to the randomization results. The primary outcome measure was the diagnostic yield, and the secondary outcomes included sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and the rate of procedure-related complications.Results 244 patients (122 conventional, 122 MOSE) were enrolled during the study period. No significant differences between the two arms were found in procedure time or rate of procedure-related adverse events. The diagnostic yield for the MOSE technique (92.6 %) was similar to that for the conventional technique (89.3 %; P = 0.37), with significantly fewer passes made (median: conventional 3, MOSE 2; P Conclusions EUS-FNTA with the MOSE technique provided a similar diagnostic yield to conventional EUS-FNTA technique in the absence of ROSE but with fewer passes. This technique can be used when ROSE is not available.

Double incision mastectomy with free nipple grafts (DIFNG) offers more flexible nipple–areola complex (NAC) resizing and repositioning in transmale and gender non-conforming individuals. The cis-male NAC has a smaller diameter, oval shape and lateral position. If nipple grafts are performed without having these considerations, aesthetics can be dissatisfying. We aim to describe the nipple split sharing technique during chest wall masculinization surgery comparing surgical, patient-reported outcomes (PRO) and aesthetic results with the conventional technique. This was a retrospective review of transmale patients who underwent DIFNG from January 2017 to January 2019. The cohort was divided into two groups: conventional and the splitting technique. Demographics, intraoperative and postoperative outcomes were recorded. In addition, PRO using Body-Q scale and aesthetic results using a Likert-based scale were analyzed. Thirty-four patients (68 breasts) underwent DIFNG. A total of 32 breasts underwent the split nipple reconstruction approach, whereas 36 underwent conventional technique. Median patient age and BMI in the nipple sharing and conventional technique groups were 27 years and 35.4 kg/m2, and 24 years and 32.2 kg/m2, respectively. Differences on postoperative complications were not statistically significant. Patient satisfaction on nipples’ module was 90.7% vs. 58.1% in the nipple sharing vs. conventional technique, respectively (p

Introduction: 24 hours traditional urine collection method is cumbersome and tedious process with less patient compliance. Our study proposes a novel fractional urine collection method for protein estimation that would entail collection of small volumes of urine each time patient voids Over 24h Period. Our aim was to compare urine protein in proposed method versus traditional 24hour sampling method. Materials and Methods: Cross-sectional, prospective study was a collaborative work between Departments of Nephrology and Biochemistry in our tertiary care hospital. Volunteers (48) and Chronic Kidney disease subjects (52) were recruited. Out of which, 76 subjects were selected. Novel method was compared with conventional method in each of these groups, before and after centrifugation and with and without preservative. Intraclass correlation coefficient (ICC) and Bland Altman analysis was used to evaluate for agreement between the two methods. Results: All the values were combined without categorization into subgroups. Fractional urine collection method (before centrifugation) without preservative (F1) and with preservative (F2) was compared to conventional method, ICC was 0.93 (C.I, 0.9 to 0.95) and 0.96 (C.I, 0.94 to 0.97) respectively. After centrifugation, fractional urine collection method for F1and F2 versus conventional method, ICC was 0.95 (C.I, 0.92 to 0.97) and 0.91 (C.I, 0.86 to 0.94) respectively. Conclusions: The novel collection method is comparable and reliable as traditional 24-hour method. The use of thymol as preservative leads to negative interference and centrifugation is mandatory before urine analysis. With proper sampling, urine protein by novel method has a good agreement with the conventional technique. Keywords: Factional, Urine protein, Traditional 24h urine, Urine creatinine.

Objectives: To compare conventional hemorrhoidectomy with harmonic scalped hemorhoidectomy for Ferguson hemorrhoidectomy is traditional closed procedure for 3rd and 4th degree hemorrhoids that is being practiced since centuries. With new innovations and technology, harmonic scalpel is an ultrasonic device which has shown to have promising results. With these two techniques a comparison study variables of pain outcome as a patient perceives, time taken for operation and length of stay in hospital. Study Design: Randomized controlled trial. Setting: Services hospital Lahore. Period: From August 2015 to February, 2016. Material & Methods: Patients were divided into two equal groups: Group A: conventional hemorrhoidectomy and Group B: Harmonic Scalpel. The study was performed by a single surgical operating team. Patient’s selection criteria were male and female between 20 to 80 ages with III and IV degree hemorrhoids. The outcomes were operative time, post-operative pain and duration of stay in the hospital. Results: One hundred patients with mean age 40.86+10.26 were included and randomly assigned. This came out significant difference in operative time 28.4+11.004, postoperative pain 3.73+1.96, and length of hospital stay 2.43+1.795. There were equal distribution in age and gender in both groups. Conclusions: It is concluded that harmonic scalpel technique in hemorrhoidectomy is better than conventional closed hemorrhoidectomy in 3rd and 4th degree hemorrhoids.

Aberrant frenum causes a problem of midline diastema which leads to unaesthetic smile for the patient. Orthodontic correction of midline diastema helps to create aesthetic smile but frenum attachment may interfere it. The labial frenectomy is the procedure performed to remove aberrant frenum attachment. This article presents two case reports of maxillary labial frenectomy by using conventional technique and Laser. Keywords: Labial Frenectomy, Midline diastema, Aesthetic smile, Laser frenectomy

Endotracheal intubation in rats is challenging due to the difficult anatomical characteristics of the airway. The success rate at first attempt is low and airway damage is a common complication. We aimed to compare and evaluate the conventional intubation method with a modified procedure using an inclined plate, headlamp (700-Lumen), and 3D mouth-piece designed with a 20° curvature. Both techniques were conducted by laboratory personnel with and without previous experience in airway management of laboratory rats.In this study, we used 36 Wistar rats of both genders. Three groups of laboratory personnel (anesthesiologists, medical students, and laboratory technicians) performed both endotracheal intubation techniques, i.e., blind intubation at supine position and endotracheal intubation at 70° supine position with a 3D mouth-piece and direct illumination of the glottis.The modified technique had a significantly higher success rate and shorter procedure duration. Moreover, there was no significant difference in the procedure duration between personnel with and without previous training in airway management.Previous knowledge and experience in airway management are required when performing conventional endotracheal intubation; moreover, its success rate is low. Contrastingly, using proper instruments and the 3D mouth-piece facilitated easier and quicker airway management regardless of previous experience.

Introduction Acetabular cup placement is an important modifiable factor determining complication rates like aseptic loosening and hip dislocation related to faulty cup placement, which by standard method is largely dependent upon eyeballing and surgeon’s judgment. We evaluated a self-designed, low-cost, patient-specific acetabular jig to guide cup placement in total hip arthroplasty in comparison to conventional technique. Methods It was a prospective randomized control study. Thirty-six patients were categorized into group-A & group-B. In group-A, virtually designed acetabular jig was 3 Dimensional (3D) printed and used intra-operatively to guide cup placement. In group-B, the standard method of cup placement was used. Acetabular cup placement was evaluated on post-operative x-rays and compared between two groups. Results In group-A, angle of anteversion were significantly in centre of range of safe zone as compared to group B in which hip is maximally stable with more precision in creating hip centre as compared to group-B without any significant(p = 0.325) increase in surgical time or blood loss. Conclusion Computed tomography (CT) scan based virtual pre-operative templating and cup placement guided by virtually designed, patient-specific acetabular jig is a low-cost tool with a short learning curve which can be designed and made available easily. It is a useful tool in decreasing chances of malpositioning of cup and recreates hip centre close to anatomical one especially in cases where anatomy has been distorted such as bony ankylosis and developmental dysplasia of hip.

Background Undescended testis (UDT) is a common congenital urogenital anomaly that is treated by orchiopexy. We aimed to introduce patent processus vaginalis (PPV) sac tightening (PVST) technique and compare it to the conventional technique. Methods We retrospectively studied all the operated UDT patients during 10 years. In the conventional technique, it was necessary to ligate PPV sac after being peeled off from the spermatic cord. PVST was dissected longitudinally from the two sides of where the PPV sac wall was attached to the spermatic cord till the proximal part, and only a narrow thin layer sticking to the spermatic cord was left and the proximal PVV sac opening was tightened as much as possible with vicryl suture at the internal inguinal ring level. The significance level was Results Of 821 orchiopexy (mean age 24.5±24.2 months), 36.3% were done by conventional and 63.7% by PVST technique. Hematoma, edema, hydrocele, and wound infection were lower in the PVST technique, but it was not significant (p>0.05). Testicular atrophy and operation time were significantly lower in the PVST than the conventional technique (p Conclusion The orchiopexy PVST technique has lower complications and seems to be easier, faster and safer than the conventional technique.

Introduction We have developed the single or double endplates penetrating screw (SEPS/DEPS) technique, which is a novel percutaneous pedicle screw (PPS) insertion technique suitable for osteoporotic vertebral body fracture (OVF) patients with diffuse idiopathic skeletal hyperostosis (DISH). This study aims to compare the effectiveness of this SEPS/DEPS technique with the conventional pedicle screw technique. Methods The screw is inserted upward from the outer caudal side of the pedicle toward the inner cranial side. Vertebrae affected with DISH were inserted with screws using the SEPS/DEPS technique, whereas non-fused vertebrae were inserted with screws using the conventional PPS technique. Twelve OVF patients with DISH were included in this study; three with SEPS/DEPS technique only and nine with a hybrid of both the DEPS and the conventional PPS techniques. As a control group, 12 OVF patients with DISH treated by conventional PPS. The rates of implant failures and of surgical complications were compared between the SEPS/DEPS group and the control group. The insertion torque was measured and compared between DEPS and conventional PPS in three hybrid patients. Results In the SEPS/DEPS group, 70 screws were inserted with the SEPS/DEPS technique and 56 screws were inserted with the conventional PPS technique. In the control group, 116 screws were inserted using the conventional PPS and the PS techniques. The loosening of screws was significantly less in screws inserted with the SEPS/DEPS technique (0/70 screws, 0%) than with screws inserted with the conventional technique (12/116 screws, 10.3%). The average insertion torque of DEPS was 2.25 Nm, which was 134% higher than that of conventional PPS which was 1.64 Nm (p = 0.04). Conclusions This novel SEPS/DEPS technique has a higher insertion torque compared with the conventional PPS techniques and demonstrated itself to be an effective option for patients with concomitant bone fragility due to DISH.

Purpose The purpose of the study was to compare the pain perception during the administration of local anaesthesia with the computerized delivery system (Wand) and conventional injection technique in paediatric dental procedures using the Visual Analogue Scale (VAS). Methods One hundred and six children from the OPD of Department of Pedodontics, Yerla Medical Trust Dental College, Navi Mumbai were included in the study. They were divided in to three groups: Group A-six years (5 years 6 months- 6 years 6 months), Group B- nine years (8 years 6 months–9 years 6 month), and Group C- twelve years (11 years 6 months–12 years 6 months). In each group, children received two interventions: the conventional local anaesthesia administration and WAND. Based on randomization by flip of the coin, the technique to be administered first was chosen. Palatal infiltration was always given first followed by the buccal infiltration irrespective of whether the WAND or the conventional technique was used. Result There was no significant difference between the mean pain perception (VAS scores) for the Wand and conventional injection technique in the 6 and 9 year old age groups. However there was significant difference between the two, among children in the 12 year age group. Conclusion there was no difference in the pain perception measured as VAS score with reference to the two techniques compared: the Wand and conventional, in all and in 6 and 9 year old children. However, the Wand technique was found to be superior in terms of lower pain for the 12 year olds. Also, among girls, the Wand technique was found to be superior.