A series of 394 radical neck dissections performed over the 17 year period 1969–1986 is presented. The shortest period of follow-up is two years. Of the major complications reviewed, wound breakdown was associated with T stage, prior radiotherapy and incision used but not with age or N stage. Cervical recurrence was associated with N stage, prior radiotherapy and surgical incision and inversely associated with age. Wound breakdown and recurrence were lowest in parotid primary tumours. Carotid artery rupture occurred in 17 patients (4.3 per cent), was fatal in all cases and was strongly associated with wound breakdown and previous radiotheraphy. The importance of the choice of incision, clearance of the posterior belly of the digastric muscle and carotied artery protection are discussed.
BackgroundApart from endoscopic interventions, readily attainable cost-effective biomarkers for ulcerative colitis (UC) assessment are required. For this purpose, we evaluated differential leucocytic ratio, mainly neutrophil–lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) as simple available indicators of disease activity in patients with ulcerative colitis.MethodsStudy conducted on 80 UC patients who were classified into two groups of 40 each according to Mayo score and colonoscopic findings. Group 1 (active UC) and group 2 (inactive UC). Another 40 group-matched healthy participants were enrolled. White blood cell count, NLR, LMR, C-reactive protein, and Erythrocyte sedimentation rate were measured and recorded.ResultsSignificant elevation of NLR was observed in active UC group compared to inactive UC and controls (2.63 ± 0.43, 1.64 ± 0.25, 1.44 ± 0.19 respectively; p < 0.0001). The optimal NLR cut-off value for active UC was > 1.91, with a sensitivity and a specificity of 90% and 90% respectively. The mean LMRs of active UC was significantly lower compared with inactive UC patients and controls (2.25 ± 0.51, 3.58 ± 0.76, 3.64 ± 0.49 respectively; p < 0.0001). The cut-off value of LMR for determining the disease activity was ≤ 2.88 with a sensitivity of 90% and a specificity of 90%. NLR, LMR, and CRP were found to be significant independent markers for discriminating disease activity (p = 0.000). Besides, NLR was significantly higher in patients with pancolitis and positively correlated with endoscopically severe disease.ConclusionNLRs and LMRs are simple non-invasive affordable independent markers of disease activity in UC.
When compared to the 40°-angled mediolateral episiotomies, 60°-angled ones were associated with significantly higher short-term-related pain. Although they were also associated with lower rate of third/fourth-degree perineal tears and higher rate of long-term related pain and dyspareunia, these differences did not reach a statistically significant level.
Studies proposed a link between gut microbiota and airway tract. Study the diversity and density of gut microbiota in healthy and asthmatic patients. Semi-quantitative stool cultures were performed from fecal samples collected from 80 adult asthmatic patients and 40 healthy individuals. Data on gender, age, dietetic history, clinical examination and investigations as skin prick test and pulmonary function testing were also collected. were found to be higher among patient group than control group. density was statistically higher in patient than control group. No significant difference was detected between male and female patients or controls. were statistically more prevalent in stool culture of male cases than that of male controls. No difference was found between female cases and controls. There was no relationship between type of microbial growth and disease related parameters including age, duration of illness, number of allergens and pulmonary function test in cases. Atopic asthma is significantly associated with gut microbiota and. It is important to determine the organism involved, to focus on microbiome-driven disease and therapies.
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