Comparative Study Of Outcomes Research Articles

Spinal Accessory to Suprascapular Nerve Transfer in Traumatic Brachial Plexus Injury: A Comparative Study of Shoulder Recovery Outcomes in the Anterior versus Posterior Approach and Surgeons' Preference

Problem statementConventionally, neural transfer of SAN to SSN for shoulder abduction in traumatic brachial plexus injury is done via the anterior approach. But important advantages of the posterior approach like the proximity of neural coaptation to the muscle to be reinnervated and negating the effects of a second injury to the suprascapular nerve have made it an alternative option. MethodologyRetrospective data was collected for a total of 30 SAN to SSN transfer patients of brachial plexus injury in two groups of 15 patients each of anterior (Group A) and posterior approach (Group B) over four years. Functional outcome at the shoulder was measured as muscle power and active range of motion (ROM) at 18 months and data on patients’ satisfaction levels and surgeons’ perceptions were also collected. ResultsNo statistical difference was found in the muscle strength achieved in the two groups (p-value = 0.34) but significant recovery was found in the external rotation achieved by group B (p-value = 0.02). Statistical difference was insignificant in the two groups' active ROM during abduction and external rotation. The satisfaction index of patients was 86.7% in the posterior approach compared to 68% in group A. Surgeons’ perspective showed a faster speed of suprascapular nerve exploration as perceived in the posterior approach with better visibility of supraspinatus muscle contraction, and overall surgeons’ preference for a posterior approach. ConclusionExternal rotation at the shoulder is better with the posterior approach but no difference in abduction. Patients with the posterior approach were more satisfied with the recovery, and surgeons preferred the posterior approach.

Abdominoplasty versus endoscopic approach to diastasis recti repair: A comparative study of outcomes

Diastasis recti (DR) is characterized by the deviation of the abdominal rectus muscle due to widening of the linea alba and laxity of the abdominal wall musculature.1,2 This condition affects the quality of life, in terms of performance of activities of daily living and physical tasks.3-7 Several techniques have been described to correct DR.11 This prospective research aimed at comparing the traditional approaches vs endoscopic plication for DR repair in terms of safety, effectiveness and satisfaction of the patients based on patient-reported outcome measures via the BODY-Q abdomen scale. Materials and MethodsWe performed a retrospective multicenter study in 2 departments of aesthetic and plastic surgery, Department of Plastic Surgery, San Carlo of Nancy Hospital, Rome (group I) and Hospital Británico de Buenos Aires, Argentina group II). A total of 85 consecutive patients treated using abdominoplasty access (group I) and 85 consecutive patients treated using an endoscopic approach (group II) were enrolled in the study. The minimum follow-up was 12 months. ResultsDescriptive statistics were used to report the counts and frequencies for categorical data. Continuous normally and non-normally distributed data were described as means with standard deviations and medians with interquartile ranges as appropriate. All analyses were performed using the STATA/IC 16.0 software. ConclusionOur multicenter experience reveals that open and minimally invasive approaches are viable options. Identifying the optimal approach for DR repair should also rely on the patient's desired treatment outcome.

A Comparative Study of the Biliary Outcome in Roux-en-Y Hepaticojejunostomy versus Duct to Duct Biliary Anastomosis in Right Lobe Living Donor Liver Transplantation in Adults

Abstract Background Recently, liver transplantation settled to be a real breakthrough in surgery as the only curable treatment to deal with fatal liver diseases. Living donor liver transplantation (LDLT) is the only available option in Egypt owing to the inactive deceased donor program. Most of the patients indicated for LDLT do not have the luxury of having an ideal living donor although we have big families in Egypt. Surgeons of recipient’s operation should occupy refined surgical skills and experience to reduce the risk of complications. The incidence of biliary complications (BCs) ranges from 5.3% to 40.6%. Leaks occur in 0% to 21.9% while strictures occur in 3.7% to 25.3%. Duct-to-duct anastomosis (D2D) and hepaticojejunostomy (HJ) are the two most common techniques of bile duct anastomosis in LDLT. D2D is gaining popularity over HJ, because of shorter operative time, fewer septic complications, a better physiologic gastrointestinal function and rapid recovery beside easier endoscopic approach to the reconstructed biliary tract. Patients and Methods The current surgical methodology is a prospective study with nonrandomized convenient sampling that was conducted at Liver Transplantation Unit in Air Forces Specialized Hospital and Nasser Institute for Research and Treatment, Cairo, Egypt, between August 2019 to August 2021. During this study, 40 patients candidate for LDLT was divided into two groups according to type of biliary anastomosis, group A included 20 recipients who had stentless duct-to-duct biliary anastomosis compared to group B including 20 recipients underwent Roux-en-Y hepaticojejunostmy. Results A total of 40 recipients were divided into two equal groups according to biliary reocstruction into group A duct-to-duct biliary anastomosis, and group B Roux-en-Y hepaticojejunostmy. The incidence of biliary related complications was higher in group A reaching 30%, double that recorded in group B (15%, p = 0.262). Upon stratification of those complications, the incidence of biliary leakage was reversed being doubled in group B 10% versus 5% in group A (p = 0.553). After exclusion of seven mortalities (one in group A and 6 in group B) who did not complete the 6 months follow-up period necessary for complete observation of BAS, there was insignificant difference between the two groups. The overall mortality was 17.5% (7 out of 8 recipients), and all died from non-biliary complication related causes. The only recipient died from biliary sepsis following ERCP and stenting for BAS, was included in the results as he died after 5 months from the operation. In a trial to understand the relation between the biliary reconstruction and the complication rate (Table 8), we found that there was a higher frequency of complications in both 1x1 and 2x2 technique in group A (33% each). In contrast, all complication happened in group B was in 1x1 technique. In addition, we could not apply the statement that the higher the number of ducts the higher the rate of complications in the study as 2 ducts grafts represent 66.7% of complications in group A compared to 100% in single duct graft in group B. Conclusion BC is a bottleneck along the path of a successful LDLT as it is multifactorial making it impossible to specify a single predictable risk factor to avoid. The advantages of D2D over HJ; especially the beneficial use of ERCP in management of complications, are buffered by the higher incidence of biliary complication that is involved with D2D. Therefore, we think that surgeons should master both reconstruction techniques and weight the risk-and-benefit case by case.

Nd:YAG laser capsulotomy vs needle aspiration in intumescent cataracts: comparative study of complications and outcomes.

To compare the complications and postoperative outcomes of Nd:YAG laser anterior capsulotomy vs a needle aspiration approach for capsulorhexis in patients with intumescent cataracts. University of Health Sciences, Basaksehir Cam and Sakura City Hospital Department of Ophthalmology, Istanbul, Turkey. Retrospective, cross-sectional study. Patients with intumescent cataract were divided into 2 groups. Group 1 (37 eyes) underwent Nd:YAG laser capsulotomy preoperatively, which reduced lens pressure. In Group 2 (31 eyes), the capsulorhexis was completed by reducing the intralenticular pressure by needle aspiration and then gradually expanding the capsule. Demographics, pre/postoperative parameters, complications, and surgical times were analyzed. 68 eyes of 68 patients were evaluated. Age and sex exhibited no significant differences between groups. Group 2 had more complications than Group 1 ( P = .041). Specifically, no capsular tear extensions were seen in Group 1 while 4 patients in Group 2 had tears extending to the lens periphery. Group 1 showed a significant decrease in surgical maneuvers and time ( P = .028) while no significant difference was found in effective phacoemulsification time ( P = .076). Nd:YAG laser capsulotomy effectively prevented capsular extensions and reduced surgical time in intumescent cataracts. This technique provides a safe alternative to traditional methods, potentially reducing intraoperative risks and improving surgical efficiency. The findings support Nd:YAG laser anterior capsulotomy as a viable approach for capsulorhexis in intumescent cataracts, emphasizing its potential benefits in reducing complications and enhancing surgical outcomes.

Comparative study of the early functional outcome of anatomic reconstruction of chronic lateral ankle instability with polyester tape reinforcement versus anchor repair

Purpose This study aims to compare the early functional outcome of anatomic reconstruction of chronic lateral ankle instability with polyester tape reinforcement versus suture anchor repair. Patients and Methods Sixty patients suffering from chronic lateral ankle instability were included. Thirty patients were treated by anatomic reconstruction of the injured ligaments and reinforcement with polyester tape and the other half was treated by suture anchors in our institution with a minimum period of 6 months follow-up. The postoperative results were assessed according to the American Orthopedic Foot and Ankle Surgery (AOFAS) scoring system for hind-foot. Results AOFAS score is improved postoperatively in both techniques without statistically significant difference (P=0.084). The results of the two techniques were comparable without statistically significant difference regarding pain, walking distance, hindfoot motion, foot alignment, activity limitation and support requirement (P=0.602, 0.067, 0.582, 0.448, 0.606, respectively). All the studied cases returned to their original activity level.

A Comparative Study of Outcomes of Submucosal Diathermy Versus Inferior Turbinoplasty in Patients With Deviated Nasal Septum With Inferior Turbinate Hypertrophy.

Introduction Nasal obstruction due to deviated nasal septum (DNS) and inferior turbinate hypertrophy (ITH) is a common problem necessitating surgical intervention. Submucosal diathermy (SMD) and inferior turbinoplasty (IT) are two commonly performed procedures aimed at improving nasal patency. Methods A prospective comparative study was conducted on 56 patients with DNS and inferior turbinate hypertrophy, divided into SMD and inferior turbinoplasty groups. Preoperative and postoperative assessments included symptom assessment using the 22-itemSinonasalOutcomeTest(SNOT-22) questionnaire. Results Both procedures led to significant improvements in nasal symptoms and quality of life. Inferior turbinoplasty showed slightly better outcomes in symptom improvement compared to submucosal diathermy. Conclusions Inferior turbinoplasty appears to offer slightly better outcomes in improving nasal symptoms compared to SMD in patients with DNS and inferior turbinate hypertrophy. However, both procedures are effective and safe options for surgical management. Individualized treatment decisions should consider patient preferences and surgeon expertise.

Direct healthcare costs in the first 2 years of life: A comparison of screened and clinically diagnosed children with cystic fibrosis – The Irish comparative outcomes study of CF (ICOS)

BackgroundIn July 2011, Cystic Fibrosis (CF) was added to the Newborn Bloodspot Screening Programme in Ireland. The Irish Comparative Outcomes Study (ICOS) is a historical cohort study established to compare outcomes between clinically-detected and screen-detected children with CF. Here we present the results of economic analysis comparing direct healthcare costs in the first 2 years of life of children born between mid-2008 and mid-2016, in the pre-CF transmembrane conductance regulator modulator era. MethodsHealthcare resource use information was obtained from Cystic Fibrosis Registry of Ireland (CFRI), medical records and parental questionnaire. Hospital admissions, emergency department visits, outpatient appointments, antibiotics and maintenance medications were included. Costs were estimated using the Health Service Executive Casemix, Irish Medicines Formulary and hospital pharmacy data, adjusted for inflation using Consumer Price Index data from the Central Statistics Office. A Negative Binomial regression was used, with time in the study as an offset. ResultsOverall participation was 93 %. After exclusion of those with meconium ileus, data from 139 patients, with follow-up to 2 years of age, were available. 72 (51.8 %) were from the clinically diagnosed cohort. In the final model (n=105), clinically diagnosed children had 2.62-fold higher costs per annum (p<0.0001), when adjusted for confounders, including homozygous ΔF508 or G511D mutation, socio-demographic factors and time between diagnosis and first CFRI interaction. ConclusionsThere are few studies evaluating economic aspects of newborn screening for CF using routine care data. These results imply that the benefits of newborn screening extend to direct healthcare costs borne by the State.

Comparative Study of Economic Learning Outcomes Using Problem Based Learning and Project Based Learning Models by Considering Student Learning Activities

This study aims to explore the effectiveness of problem-based (PBL) and project-based (PjBL) learning models on students' economic learning outcomes with different learning activity levels. Using a quasi-experimental method with a 2x2 factorial design and a purposive sample of 67 students, data were collected through interviews, observations, documentation, tests, and experiments. Hypothesis testing was done with two-way ANOVA and t-test of two independent samples. The results showed no significant difference in economic learning outcomes between PBL and PjBL models. However, there was a significant difference between students with high and low learning activities. The average learning outcomes of students with high learning activities were better using PjBL, while students with low learning activities were better using PBL. There was no significant interaction between learning models and learning activities on economic learning outcomes. This research provides important insights for educators in choosing the appropriate learning model to improve economic learning outcomes.

A Comparative Study of Maternal and Foetal Outcome between Reversed Breech Extraction Technique and Foetal Pillow, During Caesarean Section in Full Dilatation (CSFD), In Second Stage of Labour

A Comparative Study of Maternal and Foetal Outcome between Reversed Breech Extraction Technique and Foetal Pillow, During Caesarean Section in Full Dilatation (CSFD), In Second Stage of Labour

Comparative Study of Functional Outcome of Posterior Tibialis Tendon Transfer to Middle Cuneiform Bone and Anterior Tibialis Tendon with Other Techniques for Management of Foot Drop

Comparative Study of Functional Outcome of Posterior Tibialis Tendon Transfer to Middle Cuneiform Bone and Anterior Tibialis Tendon with Other Techniques for Management of Foot Drop

Comparative Study of Outcome in Cessation Therapy of Smoked Form of Tobacco and Factors Affecting It Using Tablet Bupropion or Nicotine Replacement Therapy

Background: Tobacco use is one of the major causes of preventable deaths and diseases in India. Standard treatment used in tobacco use disorder can be broadly categorized as nicotine replacement therapy (NRT) and nonnicotine pharmacotherapy. Aims: The aim of this study was to compare the outcome of tobacco cessation in subjects using the smoked form of tobacco, using tablet bupropion or NRT, and to assess various factors influencing the outcome. Settings and Design: Twelve-week follow-up study was conducted in patients of tobacco use disorder attending the outpatient department of psychiatry in a tertiary care teaching institute for a duration of 12 months, after permission from the institutional ethical committee. Materials and Methods: Hundred subjects were taken as per the inclusion criteria. After obtaining the general sociodemographic data, the severity of tobacco dependence was assessed by Fagerstrom Scale at baseline, 2 weeks, 4 weeks, 8 weeks, and 12 weeks after assigning intervention (tablet bupropion or NRT) of their choice. Statistical Analysis Used: SPSS software is used for statistical analysis. Pearson correlation, analysis of variance, and multiple regression analysis were done and P &lt; 0.05 was considered to be significant. Results and Conclusion: NRT works better in all groups of patients having mild, moderate, or severe tobacco dependence, whereas bupropion works better in groups of patients having moderate-to-severe tobacco dependence.

Comparative study of functional outcome in single plating and dual plating of unstable distal femur fractures

Comparative study of functional outcome in single plating and dual plating of unstable distal femur fractures

Caregiving burden of parents of children with cystic fibrosis in Ireland: the Irish Comparative Outcomes Study (ICOS)

Caregiving burden of parents of children with cystic fibrosis in Ireland: the Irish Comparative Outcomes Study (ICOS)

P124 Assessment of the impact of the newborn screening programme on lung function in children with cystic fibrosis in Ireland: The Irish Comparative Outcomes Study (ICOS)

P124 Assessment of the impact of the newborn screening programme on lung function in children with cystic fibrosis in Ireland: The Irish Comparative Outcomes Study (ICOS)

Traditional Hands-On Puzzle Method versus Fully Digital Approach in Teaching Tooth Morphology: A Comparative Study of Educational Outcomes.

Tooth morphology education is a critical component of dental curricula, providing a foundational understanding of the intricate structural anatomy of teeth. This study evaluates the learning outcomes in relation to tooth morphology of two student cohorts from different academic terms, comparing the traditional 'tooth puzzle' method to an alternative fully digital approach. Two groups of Master of Dentistry students were retrospectively analyzed. The control group (55 students) was taught via the 'tooth puzzle' method in 2021, while the experimental group (55 students) underwent a fully digital course in 2020 due to COVID-19 restrictions. Both groups completed a digital examination involving the identification of 40 teeth, presented as images and videos. In the control group of 55 students, nearly half (49.1%) achieved faultless results, while 65.5% had at most two faults, and 74.5% had no more than four faults. The group had a total of 163 faults, averaging 3.0 per student, with only one student (1.8%) failing the test. In stark contrast, the experimental group had no students without faults, 9.1% had four or fewer faults, and a significant 61.8% made 10 or more faults, with 29.1% failing their first test attempt by exceeding 12 faults. Overall, the experimental group registered 582 faults, averaging 10.6 per student. The 'tooth puzzle' method, with its interactive and tactile elements, proved more effective in teaching tooth morphology than the digital-only approach. The increased number of faults and failed tests in the experimental group suggest that while digital tools offer meaningful support in learning tooth morphology, their main advantage is seen when coupled with traditional hands-on techniques, not unassisted and independently.

A comparative study on outcome of endonasal dacryocystorhinostomy with and without silicone intubation-otorhinolaryngology

Background: Epiphora or “tearing eye” is a functionally and socially, bothersome symptom. Dacryocystitis is an inflammatory condition of the nasolacrimal sac caused due to an obstruction within the nasolacrimal duct (NLD). Dacryocystitis can be classified as acute and chronic or acquired and congenital. Chronic dacryocystitis is almost always managed surgically. The present study was undertaken for comparative study of outcomes of endonasal Dacryocystorhinostomy (DCR) done with and without silicone intubation. Methods: The 50 cases dacryocystitis were selected. The patients were divided in group A cases (with intubation) and group B controls (without intubation) randomly. A detailed history was taken followed by general physical and clinical otorhinolaryngological examination. Patients were evaluated with nasal endoscopy, DCG (Dacrocystogram), through which site of obstruction was located. Results: In our study, Among the cases 18 subject presented with right dacryocystitis and 7 with left dacryocystitis. Similarly, among the controls, 20 subjects presented with right dacryocystitis and 5 presented with left dacryocystitis. According to modified Likert’s score, at the end of 6 months when a nasal endoscopy was done along with syringing 96% of the cases had patent rhinostomy while only 80% of the controls showed patency. Post operative epistaxis was evident in 6 cases and 4 controls. Conclusions: Endonasal DCR with and without stenting, had more or less similar results, with equal post op complications. Though, with stenting, success rates were high as shown in our study.

A Comparative Study of Functional Outcomes in Unstable Pelvic Ring Fractures Treated With Internal Fixator (INFIX) With and Without Sacroiliac Joint Screw Fixation.

Introduction Despite constituting only 3-8% of orthopedic trauma cases, pelvic injuries are associated with high mortality rates, emphasizing the critical need for stable fixation rather than merely anatomical alignment. The use of an anterior, subcutaneous, internal pelvic fixator (INFIX), a novel technique, has shown promise in treating these injuries. Posterior pelvic ring injuries are challenging because they require a significant level of surgical training and technical expertise, and each treatment method has disadvantages. The aim of this study is to compare the clinical and biomechanical outcomes of INFIX with and without sacroiliac screw fixation for unstable pelvic fractures. Methods and methodology Retrospectively, we selected 20 patients with unstable pelvic ring injuries who had come to a high-volume tertiary care hospital and medical college in the state of Maharashtra, India. All the patients were operated on with INFIX; 10 with a sacroiliac joint screw and 10 without a sacroiliac joint screw. We followed up with the patients for six months and evaluated them according to the Majeed score. Results Functional outcomesdiffered little between INFIX patients operated on with and without a sacroiliac joint screw. However, morbidity, hospital stay, the need for ICU, radiation exposure, and technical ease of surgery were improved in INFIX patients without the sacroiliac screw procedure. We noted an average Majeed score of 78 in the INFIX-alone group and 77.2 in the group that received INFIX with a sacroiliac joint screw. Six months after the surgery, the patients showed signs of a stable bony union, had achieved a full range of motion, and reported no problems in their day-to-day work. Conclusion Although this was a short-term study, we conclude that INFIX without a sacroiliac joint screw showed a comparable functional outcome compared to INFIX with a sacroiliac joint screw. Patients with INFIX alone showed better results; they had reduced surgical time, reduced radiation exposure, and less evidence of neurological harm to the L5-S1 nerve root. The procedure was less complicated and easier for surgeons to learn. Its simplicity and speed were especially beneficial for obese patients.

PlasmaBlade versus Electrocautery for Deep Inferior Epigastric Perforator Flap Harvesting in Autologous Breast Reconstruction: A Comparative Clinical Outcome Study.

(1) Background: DIEP-based breast reconstruction necessitates wide undermining at the abdominal donor site, creating large wound areas. Flap harvesting is usually conducted using electrosurgical dissection devices. This study sought to compare the clinical outcomes in patients after using the PEAK PlasmaBlade (PPB) versus monopolar electrocautery (MPE). (2) Methods: This retrospective cohort study included 128 patients with DIEP-based breast reconstruction. Patient characteristics and information on the postoperative course were collected and a comparative evaluation was conducted. (3) Results: The MPE group exhibited significantly (p* = 0.0324) higher abdominal drainage volume (351.11 ± 185.96 mL) compared to the PPB group (279.38 ± 183.38 mL). A subgroup analysis demonstrated that PPB significantly reduced postoperative wound fluid in patients with BMI > 30 kg/m2 (p* = 0.0284), without prior neoadjuvant chemotherapy (p** = 0.0041), and among non-smokers (p = 0.0046). Furthermore, postoperative pain was significantly (p**** < 0.0001) lower in the PPB cohort. (4) Conclusions: This study confirms the non-inferiority of the PEAK PlasmaBlade to conventional electrocautery for abdominal flap harvesting. The PPB demonstrated advantages, notably reduced drainage volume and lower postoperative pain levels. Recognizing patient subsets that benefit more from the PPB highlights the importance of personalized device selection based on patient characteristics.

A Comparative Study of Endoscopic Septoplasty and Conventional Septoplasty Outcomes

A Comparative Study of Endoscopic Septoplasty and Conventional Septoplasty Outcomes

Comparative Study of Fetomaternal Outcome in Abruptio Placenta and Placenta Previa

Background: Abruptio placenta and placenta previa are obstetric complications associated with significant risks for both the fetus and the mother, potentially leading to severe hemorrhage, preterm birth, and maternal shock. Early detection and prompt medical intervention are crucial for optimizing outcomes and reducing maternal and fetal morbidity and mortality.&#x0D; Objective: The study aims to analyze the maternal and perinatal outcomes of APH cases due to placenta previa and abruptio placenta.&#x0D; Methods: This prospective study conducted at Ad Din Akij Medical College, Boyra, Khulna July 1, 2021, to June 30, 2023, included 150 APH cases, with 109 meeting inclusion criteria for comparison between placenta previa and abruptio placenta. Data collection encompassed maternal demographics, obstetric history, severity of hemorrhage, and neonatal outcomes. Diagnosis was based on clinical evaluation and ultrasound. Statistical analysis was performed using MS Excel.&#x0D; Results: In our Study, the distribution of causes of placental issues reveals that Placenta Previa accounts for the majority, comprising 71.55% of cases, while Abruptio Placentae represents 28.44% of instances. Placenta Previa predominantly affects individuals aged 26-30 years and over 35 years, with the highest occurrence among those with 2 pregnancies. Conversely, Abruptio Placentae shows a varied distribution across age groups, with the highest incidence among those aged 31-35 years and with gravidity of 1 pregnancy. Gestationally, the majority of Abruptio Placentae cases present between 31-33 weeks, while Placenta Previa cases peak at 34-36.6 weeks. Preterm births are prevalent in both conditions, with Placenta Previa leading in preterm deliveries. Placenta Previa is associated with a history of abortion and dilation and curettage (D&amp;C), while hypertension is a significant risk factor for Abruptio Placentae. Maternal complications include anemia, postpartum hemorrhage (PPH), and shock, with Placenta Previa being associated with anemia and PPH, while Abruptio Placentae correlated with shock.&#x0D; Conclusion: Placenta previa emerged as the primary cause of APH, affecting multiparous women, while abruptio placenta correlated with hypertension and primigravida. Both conditions posed significant risks of maternal and perinatal morbidity and mortality, highlighting the importance of prompt diagnosis and intervention.