INTRODUCTIONAllergic rhinitis is a common inflammatory condition of the upper respiratory tract and is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. Frequently, there is associated palate, throat, ear, and eye itching as well as eye redness, puffiness, and watery discharge. The symptoms of allergic rhinitis result from a complex allergen-driven mucosal inflammation caused by interplay between resident and infiltrating inflammatory cells and a number of vasoactive and proinflammatory ABSTRACT Background: Allergic rhinitis (AR) is a global health problem. Almost 10%-25% of population worldwide is affected by AR. Seasonal allergic rhinitis (SAR) is caused by an IgE-mediated reaction to seasonal aeroallergens and is fairly easy to identify because of the rapid and reproducible onset and offset of symptoms in association with pollen exposure. SAR can result in hyperresponsiveness to allergens. Treatment of allergic rhinitis is aimed to achieve optimal symptom control and reduce nasal congestion, sneezing and rhinorrhea over the course of the entire day and night. Methods: Out of total 274 subjects, 92 subjects in the FDC of montelukast 10 mg and levocetrizine 5 mg group, 92 subjects in montelukast 10 mg group and 90 subjects in levocetrizine 5 mg group were enrolled in the study. The total study duration was 16 days. Criteria for evaluation of primary efficacy were mean change in day time nasal symptoms score from baseline to end of treatment. Mean change in night time symptoms score from baseline to end of treatment. Mean change in day time eye symptoms score from baseline to end of treatment. Patient's and physician's global evaluation of allergic rhinitis at the end of treatment. Mean change in rhinoconjunctivitis quality-of life score from baseline to end of treatment. Results: Primary efficacy endpoint that fixed dose combination (FDC) of montelukast 10 mg and levocetirizine 5 mg was superior to montelukast 10 mg monotherapy or levocetirizine 5mg monotherapy in the treatment of patients with seasonal allergic rhinitis. Other secondary endpoints and global impression results are also supporting the therapeutic benefit of fixed dose combination over monotherapy. Conclusions: FDC of montelukast 10 mg and levocetirizine 5 mg was superior to montelukast 10 mg monotherapy or levocetirizine 5 mg monotherapy in the treatment of patients with seasonal allergic rhinitis.
Background: The tibia is the most commonly fractured bone of all the long bones in the body. In-spite of advances in treatment, fractures of tibia still pose a challenge to the orthopaedic surgeon as to their best method of management. Vulnerability of soft tissues and increased incidence of open fractures further complicates these fractures. Minimally invasive percutaneous plate osteosynthesis is one of the modalities of treatment of tibial diaphyseal fractures which causes minimal disturbance of blood supply and preserves the soft tissues around the fracture site. The aim of our study is to show the results of treatment of tibial diaphyseal fractures using MIPPO technique. Patients and methods: Our study included fifty patients with tibial diaphyseal fractures treated with locking compression plate using MIPPO technique. Fourteen patients had associated skeletal injuries. Ten patients had a type one open fracture. Results: All the fractures united at an average of 22.25 weeks. Forty patients (80%) were pain free, six patients (12%) had occasional pain (no limitation of activities) and four patients (8%) had persistent pain with limitation of daily activities. 46 (88%) had excellent or good results and 4 (8%) had poor results. 4 (8%) patients had delayed union and 1(2%) patient developed superficial skin infection, 6 patients (12%) had a palpable hardware and 3 patients (6%) had ankle stiffness.Conclusion: Minimally invasive plate osteosynthesis is a good and safe technique for treatment of tibial diaphyseal fractures providing fracture healing, rapid functional recovery, with minimal soft tissue damage and preservation of blood supply. It is a reliable approach for the management of tibial diaphyseal fractures with proper indications.
<p class="abstract"><strong>Background:</strong> One of the important functions of nose is mucociliary transport by its epithelium. Any structural abnormalities of nose like deviated nasal septum, turbinate hypertrophy and polyps can easily damage the mucociliary clearance. This can lead to increased inflammation leading to osteomeatal complex obstruction and sinusitis. The purpose of the study is to determine the nasal mucociliary clearance time (NMC) in patients with deviated nasal septum. And to compare the changes in nasal mucociliary clearance time before and after septoplasty and septoplasty with turbinectomy.</p><p class="abstract"><strong>Methods:</strong> Nasal mucociliary clearance time was measured preoperatively in patients with deviated nasal septum on concave and convex side. Post operatively it was again recorded after septoplasty in group A and septoplasty with turbinectomy in group B. These values were compared with the control group C. </p><p class="abstract"><strong>Results:</strong> Postoperatively group A patients NMC time was 11.11±2.76 on convex side, 14.01±2.39 on concave side. In group B patients NMC time was 11.18±1.91 on convex side and 12.62±1.42 on concave side.</p><p class="abstract"><strong>Conclusions:</strong> Nasal septal deviation and hypertrophied inferior turbinates can cause considerable impairment of nasal mucociliary clearance. Septoplasty combined with partial inferior turbinectomy of compensatory hypertrophied inferior turbinate on concave side preserves the normal NMC mechanism on both the sides of nasal cavity than just septoplasty.</p>
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