DESIGN: Saliva samples were collected after the morning meal by placing a sterile cotton swab in the vestibule of the oral cavity from cleft lip and palate patients immediately preoperative and 12 weeks postoperative. Normal children were examined as a control group. Samples were cultured; Staphylococcus and Streptococcus isolates were identified and quantified.
PATIENTS: Fifteen cleft lip and palate patients and 22 normal children, aged 3 to 39 months were examined.
RESULTS: Streptococcus mitis biovar 1, Streptococcus salivarius and Streptococcus oralis of the viridans group of streptococci were the most commonly found in normal children, as well as in cleft lip and palate children. In the cleft lip and palate group, mean streptococcal count was 32.41 (29.80) and 46.46 (42.80) in the pre- and postoperative periods, respectively; in the normal group, the count was 20.93 (27.93) and 49.92 (34.72) at 0 week and 12 weeks, respectively. Staphylococcus aureus was the most common Staphylococcus species found in CLP patients, representing 47.4% postoperatively. In the cleft lip and palate children, mean staphylococcal count was 5.34 (8.13) and 0.56 (0.92) in the pre- and postoperative periods, respectively; in normal children, the count was 0.82 (1.98) and 0.60 (2.55) at 0 and 12 weeks, respectively. The differences were statistically significant only for the staphylococcal count between pre- and postoperative periods in children with cleft lip and palate as tested by analysis of variance (p < .05).
CONCLUSIONS: Cleft lip and palate patients had more colonization by S. aureus compared with normal children, and the colony count decreased significantly following surgical repair of the cleft lip and palate.
MATERIAL AND METHODS: This is a retrospective study of epilepsy cases with VEM performed in University Malaya Medical Center (UMMC), Kuala Lumpur, from January 2012 till August 2016.
RESULTS: A total of 137 cases were included. The mean age was 34.5 years old (range 15-62) and 76 (55.8 %) were male. On the first 24 -h of recording (D1), 81 cases (59.1 %) had seizure occurrence, and 109 (79.6 %) by day 2 (D2). One-hundred and nine VEMs (79.6 %) were diagnostic, in guiding surgical decision or further investigations. Of these, 21 had less than 2 seizures recorded in the first 48 h but were considered as diagnostic because of concordant interictal ± ictal activities, or a diagnosis such as psychogenic non-epileptic seizure was made. Twenty-eight patients had extension of VEM for another 24-48 h, and 11 developed seizures during the extension period. Extra-temporal lobe epilepsy and seizure frequency were significant predictors for diagnostic 48 -h VEM. Three patients developed complications, including status epilepticus required anaesthetic agents (1), seizure clusters (2) with postictal psychosis or dysphasia, and all recovered subsequently.
CONCLUSIONS: 48-h video EEG monitoring is cost-effective in resource limited setting.
METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography.
RESULTS: Mean S' values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001).
CONCLUSION: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.
MATERIALS AND METHODS: The HRCT and MR imaging in 46 cochlear implant patients in our department were reviewed.
RESULTS: Majority of our patients [34 patients (73.9%)] showed normal HRCT of the temporal bone; 5 (10.9%) patients had labyrinthitis ossificans, 2 (4.3%) had Mondini's abnormality and 2 (4.3%) had middle ear effusion. One patient each had high jugular bulb, hypoplasia of the internal auditory canal and single cochlear cavity, respectively.
CONCLUSION: The above findings contribute significantly to our surgical decisions regarding candidacy for surgery, side selection and surgical technique in cochlear implantation.
METHOD: A single, masked, controlled study was designed. This comprised two matched groups of 12 chronically ACLD patients awaiting reconstruction and a group of 12 matched uninjured control subjects. Only one ACLD group received a home-based exercise and educational programme. Assessment before and after the exercise intervention included: knee joint stability (clinical and KT1000 evaluation); muscle strength (Cybex II); standing balance and functional performance (agility, [corrected] and subjective tests).
RESULTS: At the time of initial assessment there were no statistically significant differences in any measures for the two ACLD groups but both ACLD groups were significantly different from the uninjured control group as regards quadriceps strength and function. Measures taken after six weeks showed no significant improvement in the untreated ACLD group or in the uninjured control group. The treated ACLD group showed significant improvement in the following measures: quadriceps strength measured at 60 degrees and 120 degrees per second (p < 0.001); single leg standing balance with eyes closed (p < 0.001); instrumented passive stability at 20 lb (89 N) force (p = 0.003); agility and subjective performance (p < 0.001). The incidence of unstable episodes had decreased in the treated ACLD group, reducing further damage to the joint.
CONCLUSION: This study leaves little doubt that pre-operative physiotherapy had a positive effect on motor function in ACLD subjects and should be prescribed routinely to maximize muscle stabilizing potential prior to reconstruction. Patients report improved stability and, in certain cases, may avoid surgery. The finding that exercise increased the passive stability of the joint was unexpected and requires further investigation.