Objective: To compare the efficacy of chemical versus electrical cautery in the management of patients presenting with anterior epistaxis in terms of frequency of bleeding. Materials and Methods: Study Design = Randomized Control Trial (RCT)Study Setting = ENT Department Benazir Bhutto Hospital, RawalpindiDuration = 6 monthsSampling Technique = Consecutive (Non Probability) A Randomized Control Trial (RCT) of six months was done after the approval of the Ethical Committee. A total of 90 cases of anterior epistaxis were randomly divided into two groups: A (electrical cautery) and B (chemical cautery) using a random number trial with 45 in each group respectively. Informed consent was taken from all patients. Patients were explained about the procedure and its risk-benefit ratio. A detailed history was taken about epistaxis from patients presenting in an emergency. The site of bleeding was assessed. Pulse and blood pressure of patients were monitored. Patients were treated on an emergency basis. The nasal cavity was inspected with the help of a nasal speculum and suction of any blood clots was done. Bleeding points were identified and sprayed with lidocaine. The bleeding area was cauterized with a silver nitrate stick or electrical cautery for a few seconds. Antibiotic ointment was applied at the site of cautery to both groups. The patient was discharged on cessation of bleeding. A Performa was given to patients to fill 48 hours, 1 week, and 2 weeks after the procedure containing questions regarding relief of symptoms. Recurrent bleed was diagnosed on a history of separate bleed from nose post-procedure that was sudden in onset, with an identifiable bleeding point on inspection by speculum, total duration of all episodes in previous 24 hours less than 30 minutes.Results: A total of 90 cases (45 in each group) were taken. The mean age was calculated and found 34.42±8.70 in Group-A and 34.29+8.94 years for group B., The male patients were 32 (71.11%) in Group-A and 30 (66.67%) in Group-B while females were 13 (28.89%) in Group-A and 15 (33.33%) in Group-B, efficacy between chemical and electrical cautery in patients with reference to frequency of bleeding was 42 (93.33%) in Group-A and 35 (77.78%) in Group-B, the p value was calculated as 0.03 which shows a significant difference. Conclusion: This study concluded that the efficacy of electrical cautery is significantly higher than chemical cautery in the management of epistaxis. However, some other trials on larger sample size are required to validate the findings of this study.
Objective: To compare the effects of Oral Moxifloxacin and topical antibiotic ear drops in patients with active mucosal chronic otitis media. Study Design: Comparative prospective study. Place and Duration of Study: Combined Military Hospital Bahawalpur, from May 2018 to Apr 2020. Methodology: A total of 100 patients with Active (mucosal) Chronic Otitis Media were included in the study. These patients were divided into two groups. The first group received oral Moxifloxacin and topical Ciprofloxacin ear drops, while the second group only received topical ciprofloxacin ear drops. Clinical success was compared in both groups regarding patients becoming asymptomatic and having a dry ear on examination. Results: 45(90%) patients in combined treatment while 35 (70%) in the topical ciprofloxacin ear drops group became asymptomatic. The Chi-square test was applied (6.25). The p-value was .124. We found that oral Moxifloxacin, in addition to topical Ciprofloxacin ear drops, is a superior treatment option in decreasing the symptoms of tubotympanic chronic otitis media (COM) than the topical ciprofloxacin ear drops when used alone. Conclusion: Moxifloxacin is an effective drug in controlling symptoms of tubotympanic chronic supportive otitis media, and its combination with topical ciprofloxacin ear drops is superior to the ciprofloxacin ear drops when used alone.
OBJECTIVE: To highlight the usefulness of ultrasonographic measurement of fetal foot length in determining fetal gestational age. STUDY DESIGN: Prospective validation study PLACE AND DURATION OF STUDY: Radiology Department Combined Military Hospital Bahawalpur from 01July 2020 to 31Dec 2020. METHODOLOGY: Women referred from our obstetrics OPD for antenatal ultrasound between 16 to 40 weeks were scrutinized through inclusion and exclusion criteria for selection in the study. Record of their age, parity, gestational age by LMP and sonographic measurement of fetal foot length were endorsed on a study proforma. After the end of study period, the data was entered in SPSS version 20 to measure Pearson correlation coefficient and R2 values for highlighting the correlation between two variables. P value < 0.01 is taken as significant. RESULTS: A total of 153 patients were included in the study. Mean age of patients in our study is 28.64 years and second parity is most frequent being 41.8%. Data entered in SPSS version 20 for regression analysis. Pearson correlation coefficient (R) is 0.988 and R2 value is 0.977 (P- 0.000) which shows powerful linear correlation between our two variables. CONCLUSION: The results of our study shows excellent reliable linear correlation between fetal foot length and gestational age by LMP. Therefore, the fetal foot length so measured by ultrasonography can be used confidently for determination of gestational age in routine or when other ultrasonographic measurement parameters become unreliable. KEYWORDS: Fetal foot length, Gestational age, Ultrasonographic age estimation.
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