Materials and Methods: Twenty patients were equally divided into two groups of transoral and transbuccal methods. The parameters such as ease of access, surgical time, occlusion, postsurgical infection, fracture gaps, scarring, and complications were noted, and the values that were compared were statistically analyzed. P < 0.05 was considered statistically significant.
Results: No significant variations were seen in the variables such as ease of access, occlusion, postsurgical infection, and fracture gaps. Surgical time was significantly less for the transoral method. Negligible scarring was noted in the transbuccal method.
Conclusion: Although both the methods were comparable, the transbuccal approach was more efficient for the mandibular angular fracture treatment.
OBJECTIVE: To identify risk factors associated with TB relapse.
METHODS: In a prospective nested case-control study, relapse cases were recruited from a cohort of pulmonary TB patients registered between July 2007 and June 2008. Four controls per case were randomly selected from the list of non-relapse patients. Three forms were used for data collection, which included interviews with the participants and review of their medical cards and TB registers. Multivariate logistic regression analysis was performed to identify independent risk factors for relapse.
RESULTS: A relapse rate of 5.7% was found. Multivariate logistic regression analysis showed that unemployment, smoking, presence of cavitations, weight gain, weight loss, non-adherence during the continuation phase and diabetes were significantly associated with relapse (P < 0.05).
CONCLUSION: Relapse rates can be reduced by ensuring that patients take their treatment regularly and are counselled effectively to stop smoking. Reinforcing the implementation of the DOTS strategy and strengthening the anti-smoking campaigns are important actions. Action to help unemployed patients, including free services and the creation of new job opportunities, should be adopted. Using rifampicin-based regimens in the treatment of cavitary TB and bi-directional screening in TB and diabetes patients are recommended.
PATIENTS AND METHODS: Over a one-year period, we randomly assigned patients with an indication for surgery for BPH and who met inclusion criteria to treatment with either PKRP or TURP. We measured prostate volume by transrectal ultrasound, relief of bladder outlet obstruction, operative time, decline in serum sodium and hemoglobin, weight of resected prostatic chips, duration of catheterization and hospital stay. Patients were evaluated one month after discharge for obstructive symptoms. Complications were also recorded.
RESULTS: Of 102 patients enrolled, 51 underwent PKRP and 51 underwent TURP. Relief of obstructive symptoms and mean operative time showed no statistically significant difference. The PKRP group had a smaller decline in hemoglobin than the TURP group (0.6 g/dL vs 1.8 g/dL, P=.01), a lower reduction in serum sodium levels (1.03 mmol/L vs 5.01 mmol/L, P=.01), a shorter catheterization time (37.2 hours versus 57.7 hours, P=.03) and a shorter hospital stay (1.5 days versus 2.6 days, P=.02). One patient in the bipolar PKRP group needed recatheterization versus four patients in the TURP group.
CONCLUSION: PKRP reduces morbidity with an outcome similar to conventional monopolar TURP in the treatment of BPH.
Material and Methods: This experimental study involved 225 bone specimens prepared from discarded bone fragments during a series of 45 knee and hip arthroplasty surgeries. The bone fragments were cut into five identical cubes and were randomly assigned to either control (positive or negative), or experimental groups (0.5% chlorhexidine, 10% povidone-iodine or 70% alcohol). The control negative was to determine pre-contamination culture. All bone specimens, except the control negative group were uniformly contaminated by dropping on the operation theatre floor. Subsequently, the dropped bone specimens except for the control positive group, were disinfected by immersing in a respective antiseptic solution for 10 minutes, before transported to the microbiology laboratory for incubation.
Results: The incidence of a positive culture from a dropped bone fragment was 86.5%. From the 37 specimens sent for each group, the incidence of positive culture was 5.4% (2 specimens) after being disinfected using chlorhexidine, 67.6% (25 specimens) using povidone-iodine and 81.1% (30 specimens) using alcohol. Simple logistic regression analysis demonstrated that chlorhexidine was significantly effective in disinfecting contaminated bones (p-value <0.001, odd ratio 0.009). Povidone-iodine and alcohol were not statistically significant (p-value 0.059 and 0.53, respectively). Organisms identified were Bacillus species and coagulase negative Staphylococcus. No gram-negative bacteria were isolated.
Conclusion: A total of 0.5% chlorhexidine is effective and superior in disinfecting contaminated bones.