Chemical Cauterization Research Articles

Comparison of the Winograd method and chemical cauterization with 10% sodium hydroxide for treating ingrown toenails

Comparison of the Winograd method and chemical cauterization with 10% sodium hydroxide for treating ingrown toenails

Attenuation of corneal neovascularization by topical low-molecular-weight heparin-taurocholate 7 without bleeding complication.

To investigate the antiangiogenic effects and safety of topically administered low-molecular-weight heparin-taurocholate 7 (LHT7) on corneal neovascularization (CoNV). Twenty-four Sprague-Dawley rats were randomly distributed into four groups of six rats each. The central corneas were cauterized using a silver/potassium nitrate solution. From 2d after cauterization, 12.5 mg/mL (low LHT7 group) or 25 mg/mL (high LHT7 group) LHT7 was topically administered three times daily; 12.5 mg/mL bevacizumab was topically administered as positive control (bevacizumab) group, with normal saline (NS) administered as negative control (NS group). The corneas were digitally photographed to calculate the CoNV percentage from the neovascularized corneal area at 1 and 2wk. The 4 study groups did not have different CoNV percentages at 1wk after injury (P>0.05). However, the low LHT, high LHT, and bevacizumab groups had significantly lower CoNV percentages than the NS group at 2wk (all P<0.05). No significant differences in CoNV percentage were found among the low LHT, high LHT, and bevacizumab groups (all P>0.05). All groups except the NS group had lower CoNV percentages at 2wk post-injury than the levels observed at 1wk (all P<0.05). Topically-administered LHT7 inhibited CoNV without complication after chemical cauterization in the rat.

A Conservative Management of Keratocyst Odentogenic Tumor Using Cornoy’s Solution And Osteoinduction using Concentrated Growth Factor Mixed with Aotogenous Bone Graft – Randomized Clinical Research.

Aim: The objective of this study is the complete elimination of the Keratocystic Odentogenic Tumor (KCOT) along with lining epithelium at the initial operation and induces osteoblastic activity using Concentrated Growth Factor (CGF) derived from autologus blood. Materials: 10 cases were involved in the study; Male: Female ratio 6:4; Maxilla: Mandible ratio 5:5, with a mean age of 36 years. Method: All cases of KCOT were treated by enucleation and chemical cauterization using cornoy’s solution followed by placement of CGF in the dead space along with aotogenous bone graft mixed with red blood corpuscular layer. Results: Results were excellent in all the patients with very good ossification at the operated site and none of our patient had recurrence or post-operative complication.. Conclusion: This conservative management of KCOT using cornoy’s solution and placement of CGF allows

Traumatic tympanic membrane perforations: an overview in tertiary care hospital

This hospital-based prospective study was conducted in the Department of Ear Nose Throat, Head and Neck Surgery, Government Medical College Srinagar, Jammu and Kashmir, for a period of 1 year from June 2013 to June 2014 with the aim of studying the aetiological factors, clinical presentation and management options for traumatic tympanic membrane perforations. A total of 50 patients with traumatic perforations of the tympanic membrane were enrolled in the study, comprising of 34 males and 16 females patients. Age of the patients ranged from 12 to 56 years, with a mean age of 32 years. The results showed that the most common mode of trauma was slaps (56%); sudden hearing loss and tinnitus were the two most common presentations (92%). Audiometry shows that the larger the tympanic membrane perforation, the larger the air–bone gap. Hearing loss was highest at the lowest frequencies and generally decreased as the frequency increased. The differences in air–bone gaps between small and large perforations were significant at all frequencies (P<0.05, Student’s t-test). Overall, 72% of patients responded to conservative management, whereas 28% needed fat myringoplasty and/or chemical cauterization.

Protective Role of PEDF-Derived Synthetic Peptide Against Experimental Diabetic Nephropathy.

Pigment epithelium-derived factor (PEDF) is a glycoprotein with complex neuroprotective, anti-angiogenic, and anti-inflammatory properties, all of which could potentially be exploited as a therapeutic option for vascular complications in diabetes. We have previously shown that PEDF-derived synthetic peptide, P5-3 (FIFVLRD) has a comparable ability with full PEDF protein to inhibit rat corneal neovascularization induced by chemical cauterization. However, the effects of PEDF peptide on experimental diabetic nephropathy remain unknown. To address the issue, we modified P5-3 to stabilize and administered the modified peptide (d-Lys-d-Lys-d-Lys-Gln-d-Pro-P5-3-Cys-amide, 0.2 nmol/day) or vehicle to streptozotocin-induced diabetic rats (STZ-rats) intraperitoneally by an osmotic mini pump for 2 weeks. We further examined the effects of modified peptide on human proximal tubular cells. Renal PEDF expression was decreased in STZ-rats. Although the peptide administration did not affect blood glucose or blood pressure, it decreased urinary excretion levels of 8-hydroxy-2'-deoxyguanosine, an oxidative stress marker, and reduced plasminogen activator inhibitor-1 (PAI-1) gene expression, and suppressed glomerular expansion in the diabetic kidneys. High glucose or advanced glycation end products stimulated oxidative stress generation and PAI-1 gene expression in tubular cells, all of which were significantly suppressed by 10 nM modified P5-3 peptide. Our present study suggests that PEDF-derived synthetic modified peptide could protect against experimental diabetic nephropathy and inhibit tubular cell damage under diabetes-like conditions through its anti-oxidative properties. Supplementation of modified P5-3 peptide may be a novel therapeutic strategy for diabetic nephropathy.

A case report and treatment recommendations for bilateral piriform sinus fistulae

Abstract Congenital piriform sinus fistulas are uncommon and controversial, both in their classification and management. Bilateral cases are extremely rare, and no management paradigm exists. We present a case of an infected left-sided intrathyroidal branchial cleft cyst with concomitant asymptomatic right-sided piriform fistula, successfully treated with surgical excision of left-sided cyst including thyroid lobectomy and right-sided chemical cauterization with 18 months follow-up.

Unicystic ameloblastoma of mandible: Nondentigerous variant – A rare case report

Ameloblastomas are benign epithelial odontogenic tumors. The World Health Organization (2005) classified ameloblastomas into solid/multicystic, extraosseous/peripheral, desmoplastic and unicystic types. Unicystic ameloblastoma (UA) is a less frequently occurring tumor and accounts for 10 to 15% of all the intraosseous ameloblastomas. Ninety percent of the UAs are found in the mandible with predominance towards molar-ramus region. Approximately 50–80% of UAs are associated with impacted tooth (dentigerous variant). This case report is an effort to bring forth a case of UA in a 35-year-old female who presented with an asymptomatic swelling involving the right and left parasymphsis region through the midline, which is uncommon for UA and is not associated with an impacted tooth (nondentigerous variant). The lesion was confirmed by histopathological evaluation, treated by complete enucleation and curettage with extraction of teeth number 31 to 35 and 41 to 45, followed by chemical cauterization with 5% Carnoy's solution, and rehabilitated with fixed partial denture after 7 months.

Therapeutic effect of common salt on umbilical granuloma in infants

Background: Umbilical granuloma is the most general umbilical difficulty in neonates and young infants. It is commonly noted by the parents owing to persistent drainage or moisture involving the umbilicus, after the cord has dried and separated. If umbilical granuloma remains untreated, it could ooze and present with persisting irritation for several months. Many treatment modalities are available for umbilical granuloma such as chemical cauterization with silver nitrate or copper sulphate, electrocauterization, cryocauterization, granuloma ligation, and surgical excision. Objective: To evaluate the therapeutic effect of common salt (table or cooking salt) on umbilical granuloma in infants. Materials and Methods: This prospective study was conducted on 50 infants with umbilical granuloma. Parents of these 50 infants were instructed on the treatment regimen and administration to the infant at their home. The treatment consisted of application of common salt on the lesion twice a day, washing 30 min later, and repeating the procedure for 5 days. Result: All 50 infants with umbilical granuloma showed complete resolution after the 5-day course of common salt treatment. Conclusion: The use of common salt in treating umbilical granuloma is simple, cost-effective, curative, and safe. It is easily administered and can be performed by parents at home.

Assessment of efficacy and tolerability of different concentrations of trichloroacetic acid vs. carbon dioxide laser in treatment of xanthelasma palpebrarum.

There are numerous methods currently available for the management of xanthelasma. These include surgical excision, laser ablation using a variety of lasers and chemical cauterization. However, each method of treatment is associated with particular limitations and side effects. To assess the clinical efficacy and tolerability of different concentrations of topical trichloroacetic acid (TCA) vs. carbon dioxide laser in the treatment of patients with xanthelasma palpebrarum. Thirty patients with xanthelasma palpebrarum were classified into four groups, treated by TCA 35%, 50%, 70%, and CO2 laser, respectively. Lipid profile was estimated for all patients. Both TCA peeling 70% and carbon dioxide laser ablation showed more significant clinical efficacy and tolerability with least number of sessions in the treatment of xanthelasma palpebrarum than 50% and 35% TCA peeling. Post-therapy erythema and hypopigmentation were more with TCA 70%. Post-therapy hyperpigmentation was more with TCA (50%). There was a significant improvement in patients with normal lipid profile than those with abnormal profile. Both TCA peeling 70% and carbon dioxide laser ablation are highly effective and well tolerated with least number of sessions in the treatment of xanthelasma palpebrarum.

Multiple Oral Condyloma Acuminatum in a Patient with HIV/AIDS: A Case Report

Condyloma acuminatum is a human papillomavirus (HPV)-induced disease that affects the mucosa and skin of the anorectum and genitalia. This condition is rarely observed in the oral mucosa. Here, we report a case of multiple condyloma acuminatum in the mouth of a 37-year-old HIV-infected male. The patient, who was a smoker, reported irregular use of antiretroviral drugs. Physical examination revealed multiple, whitish lesions, with a vegetative aspect, that were distributed over the palate, tongue, lip, buccal mucosa, and gingiva. An incisional biopsy was performed, and the histopathological examination confirmed the diagnosis of condyloma acuminatum. The treatment plan included the surgical removal and chemical cauterization of lesions with trichloroacetic acid. However, there were some recurrences during the course of treatment. This case demonstrates the importance of correct diagnosis and planning for HPV-induced lesions, because of the risk for recurrences.

Prophylactic effect of topical silica nanoparticles as a novel antineovascularization agent for inhibiting corneal neovascularization following chemical burn.

Background:Angiogenesis-related corneal blindness includes the spectrum of corneal diseases that are caused by pathological angiogenesis, leading to untoward visual impairment. The purpose of this study was to investigate the antineovascularization effect of topical silica nanoparticles (SiNPs) in inhibiting chemical-burn-induced corneal neovascularization.Materials and Methods:A total number of 20 corneas of 10 Wistar Albino rats were included in this study. Silver nitrate cauterization was pressed to the central cornea for 5 s to induce corneal neovascularization. They were randomly allocated to case and control groups (ten eyes in each group). SiNPs were synthesized by the reverse microemulsion method. SiNPs drop 1 mg/ml was started in ten eyes and artificial tear drop was started in the control group (ten eyes) immediately after chemical cauterization. Video-based photography was performed before and after treatment. Corneal image analysis was performed on each cornea using an image analysis software program. All rats were euthanized and the eyes were sent for histopathologic examinations14 days after chemical cauterization.Results:Scanning electron microscopy (SEM) images showed spherical-shaped particles. The mean size and polydispersity index of prepared SiNPs were 30.1 ± 5.6 nm and 0.254 ± 0.11, respectively. Fourteen days after chemical cauterization, the mean vascularized corneal area was 21% of total corneal area in the case group and 85% in the control group (P < 0.05). The control group revealed more extensive intrastromal vascularization compared with the case group in histopathologic examinations (P < 0.05).Conclusions:SiNPs is an effective modality for inhibiting corneal neovascularization following chemical burn in an experimental model. Further investigations are suggested for evaluation of its safety and efficacy in human eyes.

Ultrapulse carbon dioxide laser ablation of xanthelasma palpebrarum: A case series

Context:Xanthelasma palpebrarum is the most common form of xanthomas. Albeit a benign entity, it is cosmetically disturbing and a frequently recurring dermatologic referral. Although the classical treatment option remains surgical excision, alternatively, chemical cauterization, cryosurgery and electrofulguration have all been tried in the past with mixed results. The use of laser systems such as carbon dioxide laser, Erb:YAG laser, Q-switched Nd:YAG laser, diode laser, pulsed dye laser and KTP laser have become popular in the treatment of these lesions. Recent literature suggests minimal pigmentary changes and scarring with the use of ultrapulse carbon dioxide laser treatment of these lesions.Aim:To study and evaluate the effectiveness of ultrapulse carbon dioxide laser ablation for treatment of xanthelasma palpebrarum.Materials and Methods:10 patients presenting with bilateral xanthelasma palpebrarum, new and with recurrence were studied for results after a single treatment with ultrapulse carbon dioxide laser (10,600 nm; 100-200 Hz; 200-400 μsec). The follow-up time was 9 months.Results:All lesions were treatable with a single-laser treatment session. Two patients (20%) developed recurrence during the follow-up period. Side effects included post inflammatory hyperpigmentation in two patients (20%), but no visible scarring was observed.Conclusions:The ultrapulse carbon dioxide laser is an effective and safe therapeutic alternative in treatment of xanthelasma palpebrarum.

Gorlin Goltz syndrome: A case report

Not many cases have been reported in India, and hence we report here a rare case of Gorlin Goltz syndrome (GGS) especially in young patients without any skin lesions. A 21 year old male reported to our department, with swelling in the lower posterior region of the right side of jaw since last 2 years. Thorough extraoral and intraoral examinations along with orthopantomogram (OPG), CT scan (skull) and chest radiograph helped in proper diagnosis of the condition. No skin lesion in the form of basal cell nevus, palmar or plantar pits, or keratosis were present. All the cystic lesions of the jaws were enucleated surgically and chemical cauterization done by Carnoy's solution. No sign of recurrence observed still date. Our case highlights the importance of the awareness of this rare syndrome, especially in young patients without any skin lesions because early verification of the disease prevent recurrence and better survival rates from the existent disease.

A Case of Pyriform Sinus Fistula Concurrent with Papillary Thyroid Carcinoma in a 72-Year-Old Patient

Since branchial anomalies are developmental disorders, pyriform sinus fistula (PSF) has been considered as a pediatric disease, and most reports of PSF with clinical symptoms have thus been on neonatal and young children. There are only a few case reports worldwide, of PSF found in adult patients. Here, we report a case where the patient’s initial symptom of PSF occurred at the age of 72. Interestingly, papillary thyroid carcinoma (PTC) was concurrently identified on computed tomography during the evaluation for PSF. Chemical cauterization and total thyroidectomy was performed for the treatment of PSF and PTC, respectively. This case report may contribute to increased awareness of PSF in adult patients and the possible coexistence of thyroid cancer in these patients.

Surgical management of a high ramal odontogenic keratocyst

Odontogenic keratocysts (OKCs) are benign, they are often locally destructive and tend to recur after conservative surgical treatment. There has been a shift in the treatment modality from conservative procedures like marsupialization and enucleation to the more conventional surgical methods. However, the recurrence rate after marsupialization, followed by enucleation is not significantly higher than that after aggressive modalities. The goals of treatment should eliminate the potential for recurrence and minimize the surgical morbidity. Future treatment may involve molecular-based modalities, which may reduce or eliminate the need for aggressive surgical management. A case report is presented in which isolated OKC at the level of sigmoid notch is treated by surgical enucleation and chemical cauterization (with Carnoy's solution).

Immunomodulators in warts: Unexplored or ineffective?

Cutaneous warts are known to be recurrent and often resistant to therapy. Resistant warts may reflect a localized or systemic cell mediated immune (CMI) deficiency to HPV. Many modalities of treatment are in use; most of the provider-administered therapies are destructive and cause scarring, such as cryotherapy, chemical cauterisation, curettage, electrodessication and laser removal. Most patient-applied agents like podophyllotoxin have the risk of application-site reactions and recurrence. Thus immunotherapy is a promising modality which could lead to resolution of warts without any physical changes or scarring and in addition would augment the host response against the causative agent, thereby leading to complete resolution and decreased recurrences. Immunomodulators can be administered systemically, intralesionally or intradermally, and topically. A few agents have been tried and studied extensively such as cimetidine and interferons; others are new on the horizon, such as Echinacea, green tea catechins and quadrivalent HPV vaccine, and their efficacy is yet to be completely established. Though some like levamisole have shown no efficacy as monotherapy and are now used only in combination, other more recent agents require large and long term randomized placebo-controlled trials to clearly establish their efficacy or lack of it. In this review, we focus on the immunomodulators that have been used for the treatment of warts and the studies that have been conducted on them.

Maxillary Artery Embolization for the Treatment of Intractable Epistaxis

Objectives: Arterial embolization has become a common treatment for intractable epistaxis. The objectives of this study are to evaluate the outcomes and optimal endovascular treatment strategy for patients undergoing embolization for intractable epistaxis. Methods: Retrospective review of patients undergoing endovascular embolization for intractable epistaxis from 2004 to 2013. Patients having tumor embolization were excluded. Vessels were embolized with polyvinyl alcohol (PVA). Data were collected concerning demographics, risk factors, management prior to embolization, vessels embolized, outcomes, and complications. Results: Forty-three patients underwent embolization for intractable epistaxis. Risk factors included uncontrolled hypertension (n = 20), anticoagulation therapy (n = 17), facial trauma (n = 4), and recent nasal or palate surgery (n = 5). Therapy attempted prior to embolization included anterior nasal packing (86%), nasopharyngeal balloon packing (42%), chemical cauterization (9%), surgical intervention (19%), prior embolization (7%), and oropharyngeal packing (2%). Vessels embolized were bilateral maxillary arteries (MA) (81%), bilateral MA with bilateral facial arteries (5%), and unilateral MA when bilateral embolization was not possible due to vessel anatomy (14%). Successful embolization, defined as resolution of bleeding prior to discharge, occurred in 35 patients. Of the 8 cases with postembolization bleeding, 6 stopped spontaneously or with minimal intervention. The rate of successful embolization was 83% for both unilateral and bilateral MA embolization. The only major complication was nasal tip and alar necrosis that occurred in 1 patient after facial artery embolization. No neurologic complications were identified. Conclusions: Maxillary artery embolization had favorable outcomes and no significant complications in the current study.

Pediatric recurrent acute suppurative thyroiditis of third branchial arch origin—Our experience in 17 cases

ObjectiveTo describe clinical presentations, management and treatment outcomes of 17 cases of congenital pyriform sinus fistula (PSF) of third branchial arch origin presenting as left recurrent acute suppurative thyroiditis with cervical abscess. MethodMedical record of these 17 cases (5-males, 12-females) presented during 2009–2013 were reviewed. ResultsAverage age was 9.6 years (range 3–15 years). Fistulous opening in neck was present in 10 cases (58.8%). Average number of episode of infection from first presentation to definitive diagnosis was 3 (range 2–5). All patient had history of incision and drainage (ID) of abscess (average 2, range 1–3). All cases had barium swallow and CT scan. Sixteen cases had telescopic hypopharyngoscopy. Barium swallow and telescopic hypopharyngoscopy detected PSF in 88.23% (15/17) and 100% (16/16) cases respectively. Fourteen cases were treated by transcervical excision (TE) (fistulectomy with left hemithyroidectomy), two cases were treated by endoscopic chemical cauterization (ECC) of internal opening at pyriform sinus using silver nitrate and only ID of abscess was done in one case. Success rate of TE and ECC was 93% and 100% respectively. Recurrence in one case initially treated by TE was managed successfully by ECC. ConclusionPresence of congenital PFS should be suspected when left-sided intra-thyroidal abscess formation occurs as gland is resistant to infection. Strong clinical suspicion, barium swallow study, telescopic pharyngoscopy and CT scan are the key to diagnosis. Both TE and ECC has comparable success rate. ECC may prove a useful and equally effective method of treatment for congenital PFS in future.

Current Role of Carnoy's Solution in Treating Keratocystic Odontogenic Tumors

Carnoy's solution, a chemical cauterization agent, is indicated as one of the treatment modalities for keratocystic odontogenic tumors (KCOTs). This solution is listed as part of the AAOMS Parameters of Care as chemical curettage for treating bone cysts. Carnoy's solution described by Voorsmit (1981) contains 100% ethanol, chloroform and glacial acetic acid in a 6:3:1 ratio with added ferric chloride. This chemical composition provides a tissue-fixation property used in histology and a tissue cauterization property utilized in chemical curettage.

A METHOD IN THE PREPARATION OF TEEKSHANA KSHARA AND IT’S PRACTICE IN HAEMORRHOIDS

Ksharakarma is a type of chemical cauterization which is performed by Kshara (caustic alkali substance) and said to be one of the important para surgical procedure s in Ayurveda . Th is Kshara is classified in to various types a mong tho se Teekshanakshara is used for Arshas (h a emorrhoids) and in other ano - rectal disorders and also its practice is well described by A charya Sushruta . However in present surgical practice due to lack of und erstanding and practical exposure in the preparation of Teekshana Kshara and its application in the h a emorrhoids is not being practiced commonly. In view of that a standard method is developed on the basis of principles explained by Acharya Sushruta . It s p reparation requ ires ash of Apamarga ( Achyranthes aspera ), Shukti ( Ostrea edulis ) and paste of Chitraka ( Plumbago zylanica ). These are taken in fixed proportions. After specific steps semisolid Teekshanakshara is prepared and preserved in tight lid bottle . This Kshara is to be applied over the haemorrhoids in lithotomic position under suitable anesthesia to the patient . Later the Kshara applied site is washed with lemon juice and post operative maintenance is followed in a standard method. After some time th e h a emorrhoid site will get s l oughed out and leads to fibrosis of mucous membrane which further avoids the recurrence of disease. This is minimal invasive procedure and better than presently available conventional methods and successfully practiced in many of the h a emorrhoids patients. Key word: Arsha, Pratisaraniyakshara , Ksharakarma, haemorrhoids