Dye Test Research Articles

Thickness, permeability and tactile perception of commercial latex examination gloves used in dental practice

Introduction: Dentists are at an increased risk of being infected. Some patients may be unaware of their infected status while some patients are unwilling to tell the dentists their disease status. Gloves should be worn in almost all patient procedures. Aim: To assess association between thickness, tactile perception, and permeability of commercial latex examination gloves used in dental practice. Materials and Methods: The experimental study was conducted in Central India. A total of 600 gloves, 120 each from five brands (Kaltex, Nulife, Smartcare, Handshield, Medi-image) were used. Thickness was measured using stereomicroscope. Permeability to fluids was evaluated through 0.2% erythrosine dye. Staphylococcus aureus (ATCC-25923) was used to check for microbial permeability. Tactile sensibility was assessed by 2-point discriminator test using 2-point-calipers on 30 volunteers. Chi-square test and Binary logistic regression analysis were used. Results: Mean thickness of gloves was 0.1333 (range: 0.1028-0.1799). Dye and microbial test showed 10.6% and 43.3% permeability of gloves, respectively. No significant difference was observed among brands. Thicker gloves (0.1285-0.1542) yielded lower touch sensibility (odds ratio: 0.783, P < 0.05). Decrease in tactility was recorded in 78.6% of volunteers with gloves compared to no gloves. Conclusion: Considerable microbial permeability suggests commercial examination gloves are unsafe. Balance between thickness, permeability and touch sensation should be established to decrease permeability maintaining same touch sensibility.

A Case of Successful Endoscopic Dacryocystorhinostomy in Nasolacrimal Duct Obstruction with Wegener Granulomatosis

Purpose: To report a case of nasolacrimal duct obstruction occurring in a patient with Wegener granulomatosis treated successfully with endoscopic dacryocystorhinostomy. Case summary: A 36-year-old female diagnosed with Wegener’s granulomatosis 3 years prior and treated with rituximab and currently taking azathioprine 100 mg presented with a 1-year history of left epiphora and mucus in the left eye. Her left tear meniscus was higher than the right and was a hard stop with lacrimal probe when a lacrimal probing test was performed. Mucus was regurgitated during lacrimal irrigation and middle turbinate was not observed due to granuloma in the nasal cavity. Dacryocystography showed proximal nasolacrimal duct obstruction and a well-defined dacryocystocele 6 x 5 x 6 mm in size was observed on the left lacrimal fossa on facial 3D computed tomography. After synechiolysis for a granuloma in the nasal cavity, endoscopic dacryocystorhinostomy was performed and silastic sheet sutured on the nasal septum to prevent resynechia. After 2 weeks and 4 months, the silastic sheet and silicon tube were removed, respectively. The patient was asymptomatic following surgery and there was no regurgitation during lacrimal irrigation test. The ostium was patent at 5 months after surgery using the endoscopic dye test. Conclusions: Nasolacrimal duct obstruction occurring in a patient with Wegener’s granulomatosis can be treated effectively with endoscopic dacryocystorhinostomy even if the nasal cavity is narrow due to granuloma. J Korean Ophthalmol Soc 2015;56(9):1454-1458

Endoscopic V/s External Approach DCR: A comparative Analysis

Aims & Objective: To compare the surgical procedures, intra-operative & post operative complications and overall success rate of Endoscopic Dacrocystorhinostomy (Endo-DCR) with External approach Dacrocystorhinostomy (DCR). Materials & Methods: In this randomized, interventional, comparative study, 50 cases of mechanical Endonasal Dacrocystorhinostomy & 30 cases of conventional External Dacrocystorhinostomy were performed from January 2006 to April 2007 in the department of Ophthalmology in conjunction with department of Otorhinolaryngology, Sir Sunder Lal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh. All patients underwent detailed general, medical and ocular history as well as thorough ocular and ENT examination to rule out any nasal pathology. Level of blockage was diagnosed by lacrimal syringing & probing, Jones dye test and dacrocystography. Surgery was done under local anesthesia except in children and uncooperative patients where general anesthesia was used. For Endo- DCR surgery, 0 & 30 degree rigid endoscope was used. In selected cases silastic sheet were used. The surgical outcomes and complications were analyzed. Results: Functional success and symptomatic relief were equivalent in both procedures. Endo-DCR surgery was found to be quicker to perform than external DCR surgery. The follow-up duration was comparable in both groups. Patient satisfaction was significantly higher in the Endo -DCR group. Conclusion: Endo-DCR surgery offers a very attractive alternative to the well established technique of external DCR surgery for the treatment of primary acquired nasolacrimal duct obstruction with equivalent success rates, shorter surgical time and higher patient satisfaction. Keywords: Chronic dacryocystitis, Endoscopic DCR, Epiphora, Endonasal DCR surgery, External DCR, Silicon intubation

Ovarian struma - report of a rare case.

A 34-year-old primipara with no live child came to the gynecology department with complaints of increased and prolonged menstrual bleeding and lower abdominal pain for three months. Her previous menstrual cycles were normal. She was married for 15 y. She was para one. It was an intrauterine death at eight months of pregnancy delivered vaginally 14 y ago. Her medical and surgical history was not significant. No history of malignancy in family. On general examination, her vitals were stable. There was no evidence of hyperthyroidism. Her systemic examination was normal. Examination of abdomen revealed no mass or ascites. Cervix was normal on speculum examination. On bimanual examination, a mobile, non-tender cystic mass measuring approximately 10x8 cm was palpable in the right and anterior fornix. Uterus was normal, left fornix felt free. Rectal examination confirmed above findings. Ultrasonogram of abdomen and pelvis showed a right adnexal cyst measuring 7x8x6.2 cm with muItiple septations. CA-125 levels were within normal limits (7.5 U/ml). Thyroid function tests were within normal limits. Exploratory laparotomy was done. Peroperatively, a multicystic mass of size 8x7x8 cm consisting of right tube and ovary was seen in the right adnexa. Uterus and left adnexa were normal. There was no ascites and no omental adhesions. As she was anxious to conceive, only right salphingo-ophorectomy was done. Dye test showed patent left fallopian tube. Postoperative period was uneventful. On gross examination, ovarian cyst measured 8x5x3 cm. External surface was bosselated and cut section revealed a multiloculated cyst with one solid area measuring 3x2x1 cm. Attached fimbrial end of the right fallopian tube measured 3 cm in length [Table/Fig-1]. [Table/Fig-1]: Gross appearance Microscopic examination showed ovarian parenchyma with cystic follicles [Table/Fig-2] and a cyst lined by a single layer of cuboidal to columnar epithelium [Table/Fig-3]. The wall of the cyst showed multiple colloid-filled thyroid follicles of varying sizes lined by a single layer of cuboidal epithelium. Sections from the right fallopian tube showed normal morphology. [Table/Fig-4,​,5].5]. A diagnosis of Benign struma ovarii - cystic variant was then made. [Table/Fig-2]: Ovarian cyst wall showing ovarian parenchyma (H and E x40) [Table/Fig-3]: Areas showing cyst wall lined by a single layer of cuboidal to columnar epithelium. (H and E x100) [Table/Fig-4]: The wall of the cyst shows multiple colloid-filled thyroid follicles of varying sizes (H and E x100) [Table/Fig-5]: Thyroid follicles lined by a single layer of cuboidal epithelium enclosing colloid (H and E x400) Struma ovarii is an uncommon gynecological tumour accounting for 1% of all ovarian tumours and 3 to 5% of all dermoid tumours of ovary [1–3]. The diagnosis rests on histopathological examination of the tissue which shows thyroid follicles filled with eosinophilic colloid. Rarely, degenerative changes such as calcification, fibrosis or hemosiderophages may be seen [4]. Surgical management is the treatment of choice for struma ovarii. For women desiring fertility, simple ovarian cystectomy or salphingo-oopherectomy seems to be optimal [4,5]. In this case, since she was young with no live child and clinically appeared benign, only right salphingo-oopherectomy was done. For benign disease, standard surgical follow up is sufficient and the prognosis is excellent [6].

Hysterosalpingo-contrast-sonography (HyCoSy) in the assessment of tubal patency in endometriosis patients

ObjectiveTubal patency in women with endometriosis has traditionally been evaluated by laparoscopy. The aim of this study was to investigate the accuracy of hysterosalpingo-contrast-sonography (HyCoSy) in the assessment of tubal patency in these women. Study designA retrospective study was conducted at Physiopathology of Human Reproduction Unit. Infertile women who underwent HyCoSy and then a laparoscopy (dye test) within 6 months from the HyCoSy were included. Tubal patency was assessed by HyCoSy and the findings were compared with the results of laparoscopy, which was considered the gold standard for assessment of tubal patency. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) and positive and negative likelihood ratios (Lh+, Lh−) were calculated including the 95% confidence interval (CI). ResultsA total of 1452 women underwent HyCoSy and 126 of them received a laparoscopy within 6 months from the HyCoSy. Of the 126 women, 42 (33.3%) had a diagnosis of pelvic endometriosis and 84 (66.7%) had no endometriosis. In the endometriosis population, HyCoSy showed a sensitivity, specificity, PPV, NPV, Lh+ and Lh− of 85% (95% CI 62–96), 93% (95% CI 82–97), 81% (95% CI 58–94), 94% (95% CI 84–98), 12.6 (95% CI 4.8–33) and 0.15 (95% CI 0.05–0.4) respectively. In the non-endometriosis group, HyCoSy showed a sensitivity, specificity, PPV, NPV, LR+ and LR− of 85% (95% CI 65–95), 93% (95% CI 87–96), 71% (95% CI 53–85), 97% (95% CI 92–99), 13.2 (95% CI 6.9–25) and 0.15 (95% CI 0.06–0.3) respectively. The diagnostic accuracy of HyCoSy was 91% in the endometriosis group and 92% in the non-endometriosis patients. ConclusionsHyCoSy showed high accuracy in evaluating tubal patency in infertile non-endometriosis women and in those affected by endometriosis.

A rapid kinetic dye test to predict the adsorption of 2-methylisoborneol onto granular activated carbons and to identify the influence of pore volume distributions

The authors have developed a kinetic dye test protocol that aims to predict the competitive adsorption of 2-methylisoborneol (MIB) to granular activated carbons (GACs). The kinetic dye test takes about two hours to perform, and produces a quantitative result, fitted to a model to yield an Intraparticle Diffusion Constant (IDC) during the earlier times of dye sorption. The dye xylenol orange was probed into six coconut-based GACs and five bituminous-based GACs that hosted varied pore distributions. Correlations between xylenol orange IDCs and breakthrough of MIB at 4 ppt in rapid small-scale column tests (RSSCTs) were found with R2s of 0.85 and 0.95 for coconut carbons that processed waters with total organic carbon (TOCs) of 1.9 and 2.2 ppm, respectively, and with an R2 of 0.94 for bituminous carbons that processed waters with a TOC of 2.5 ppm. The author sought to study the influence of the pore sizes, which provide the adsorption sites and the diffusion conduits that are necessary for the removal of those compounds. For coconut carbons, a linear correlation was established between the xylenol orange IDCs and the volume of pores in the range of 23.4–31.8 Å widths (R2 = 0.98). For bituminous carbons, best correlation was to pores ranging from 74 to 93 Å widths (R2 = 0.94). The differences in adsorption between coconut carbons and bituminous carbons have been attributed to the inherently dissimilar graphene layering resulting from the parent materials and the activation processes. When fluorescein dye was employed in the kinetic dye tests, the correlations to RSSCT-MIB performance were not as high as when xylenol orange was used. Intriguingly, it was the same pore size ranges that exhibited the strongest correlation for MIB RSSCT's, xylenol orange kinetics, and fluoroscein kinetics. When methylene blue dye was used, sorption occurred so rapidly as to be out of the scope of the IDC model.

Structure and Properties of Regenerated Cellulose Filaments Prepared from Cellulose Carbamate–NaOH/ZnO Aqueous Solution

In this work, regenerated cellulose (RC) filaments were successfully spun from cellulose carbamate in a NaOH/ZnO aqueous solution on a pilot scale. The structure and properties of the RC filaments were characterized using SEM, FT-IR, elemental analysis, 13C NMR, XRD, 2D WAXD, tensile testing, and dye testing. The nitrogen-free and sulfur-free RC filaments exhibited a bright surface and circular cross section. The filaments demonstrated a typical cellulose II crystal structure and a relatively high degree of orientation. Improved tenacity and structure were obtained in the RC fibers due to improved post-processing spinning steps and an increased drawing ratio. The tenacity of the fibers was determined in the range of 1.69–2.36 cN/dtex, which was comparable with that of commercial viscose rayon. Furthermore, the RC filaments showed improved dye properties compared with viscose rayon. The described carbamate pathway provided a simple and environmentally friendly method, offering an alternate to the environmental drawbacks of the viscose process.

A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction

PurposeTo compare the success rates of probing versus bicanalicular silastic intubation as the primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children ≥1 year old.Study designProspective, randomised, comparison.MethodsParticipants were...

Characterization of Subglacial Pathways Draining Two Tributary Meltwater Streams through the Lower Ablation Zone of Gangotri Glacier System, Garhwal Himalaya, India

An attempt has been made to characterize the subglacial pathways that transport the meltwaters from Chaturangi and Raktavarn glaciers through the lower ablation zone of the Gangotri glacier, Indian Himalaya, by means of dye tracer experiments. These inactive tributaries of the Gangotri glacier contribute significantly to the proglacial discharge, which is dominantly controlled by air temperature (0-20°C at the measurement site) rather than rainfall (117 mm from June to September 2008). The breakthrough flow velocities, ranging from 0.6 to 1.7 ms -1 and dispersivity values varying between 2.1 and 17.5 m, decreased with bulk discharges in the proglacial stream (R 2 = 0.66), indicating flow through highly efficient subglacial channels that develop during the melt season with increased meltwater influx. However, the dye return curves giving high velocities in a narrow range from 1.3 to 1.7 ms -1 as seasonal discharges were peaking, are interpreted as indicative of flow through pressurized channel/s. In general, the subglacial channels routing meltwater from these input points are arguably controlled by recharge hydrographs rather than channel geometry during the ablation season. Closely spaced dye tests need to be carried out to better understand the factors that control the diurnal and seasonal development of these hydrological pathways, which are important for downstream water management.

Endoscopic vs external dacryocystorhinostomy-comparison from the patients' aspect.

To compare the success and complication rates, duration of surgeries and clinical comfort after endoscopic dacryocystorhinostomy (END-DCR) or external dacryocystorhinostomy (EXT-DCR). Fifty patients who underwent EXT- or END-DCR between January 2010-2012 were involved in the study. A questionnaire was applied to patients preoperatively, and postoperatively. Subjective success was defined by absence of epiphora, objective success by a normal nasolacrimal lavage and a positive functional endoscopic dye test (FEDT). Postoperative pain and cosmetic result of surgery were interpreted by the patients, who were also asked whether they would offer this surgery to a friend or would prefer this surgery once more if necessary. Twenty-five patients underwent END-DCR and 25 underwent EXT-DCR. Mean duration of surgeries were 35min both for EXT-DCR (30-50) and END-DCR (35-50) (P=0.778). Intraoperative bleeding were documented in 48% of EXT-DCR and 4% of END-DCR cases (P<0.001). In total 96% of EXT-DCR and 100% of END-DCR patients had subjective success. Objective success was 100% in each group. There was no significant difference between the epiphora scorings and FDDT results in postoperative visits among the groups. END-DCR group reported less pain in first week and month (P<0.05, P<0.05). More patients in END-DCR group were happy with the cosmetic result in first week and month (P<0.001, P<0.001). More patients in END-DCR group offered this surgery to a friend (P<0.001). All patients in END-DCR group preferred this surgery once more if necessary, only 48% in EXT-DCR preferred the same method (P<0.001). Although both END- and EXT-DCRs provide satisfactory outcomes with similar objective and subjective success rates, we demonstrated that the endonasal approach caused significantly less pain in early postoperative period than the external approach. Clinical comfort defined by the patients was quite higher in END-DCR group, in which patients mainly were pleased to encounter a sutureless surgical area.

The safety and acceptability of saline infusion sonography versus hysterosalpingography for evaluation of tubal patency in infertile women

Abstract Objective To assess the efficacy, safety and acceptability of saline infusion sonography (SIS) in comparison to hysterosalpingography (HSG) in the evaluation of tubal patency in infertile women. Materials and methods In this prospective study, 104 consecutive infertile women underwent SIS and HSG for tubal patency followed by laparoscopy with dye test as the gold standard test. Test parameters, safety and acceptability of both methods were assessed. Results SIS showed patency in 90 (86.5%) tubes, HSG in 85 (81.7%) tubes, and laparoscopy in 75 (72.1%) tubes. SIS and laparoscopy agreed in 15 out of 29 occluded tubes (concordance, 51.7%) while HSG and laparoscopy agreed in 11 out of 29 occluded tubes (concordance, 37.9%). The sensitivity, specificity, PPV, NPV were 52%, 95%, 79%, 84% for SIS and 38%, 96%, 79%, 80% for HSG respectively. There were a significant number of women who experienced pain, syncopy and cervicovaginal lacerations during HSG examination in comparison to SIS ( P Conclusion Although HSG is the standard screening test for the diagnosis of tubal infertility, the present study confirmed the higher sensitivity, safety and acceptability of SIS compared to HSG for the evaluation of tubal patency in infertile women.

Interpreting Dye Test Results for Improved Drip Irrigation Management for the Mulched Vegetable-Production Systems in South Florida

On-farm dye tests provide simple, low-cost methods to understand how water and dissolved nutrients (e.g., nitrogen) will move within beds at a given farm. If it is not feasible for the grower to conduct an on-farm dye test, results from a dye test with similar site characteristics—including region, soil type, bed geometry, and drip tape—can be used. The intent of this publication is to explain procedures of a dye test and describe the movement pattern for Immokalee fine sand, a typical soil found in central and south Florida. We also show the effect of antecedent soil moisture on water movement in the bed. This 6-page fact sheet was written by Sanjay Shukla, Nathan Holt, and Gregory Hendricks, and published by the UF Department of Agricultural and Biological Engineering, July 2014.

Cadmium selenide@sulfide nanoparticle composites: Facile precipitation preparation, characterization, and investigation of their photocatalyst activity

We report a two-step synthesis and structural characterization of CdSe/CdS core/shell nanoparticles by the precipitation method. Besides, the effects of preparation parameters such as reaction temperature, the speed of the reaction stirrer, and the rate of adding sulfide source on the size, morphology, and photocatalyst activity of CdSe/CdS core–shell nanoparticles were studied by SEM images and degradation of methyl orange (MO) dye test. The structure and composition of the obtained products were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), high-resolution field-emission transmission electron microscope (HRTEM), photoluminescence spectroscopy (PL), scanning electronic microscopy (SEM), spectra energy dispersive analysis of X-ray (EDS), and ultraviolet–visible (UV–vis) techniques.

Seroprevalance of brucellosis, listeriosis and toxoplasmosis in cattle in Adana province of Turkey

This study was conducted to identify the seroprevalance of diseases which are zoonotic and responsible from abortion such as toxoplasmosis, listeriosis and brucellosis in Holstein crossbred cattle of different age and sex in Adana province, between 2008 April-September. For this purpose, blood serum samples were collected from 132 cattle and analyzed for Toxoplasma gondii, Listeria monocytogenes and Brucella abortus antibodies. T. gondii, L. monocytogenes and Brucella abortus antibodies were determined by the standard Sabin- Feldman Dye Test (SFDT), Osebold method and Microtube Agglutination Test (MAT) respectively, from the blood serum samples. 132 serum tested 56.06% samples of T. gondii, 40.9% and 3.03% of L. monocytogenes and defined the B.abortus antibodies were found to be seropositive terms. There were no statistically significant difference between seropositive T. gondii, L. monocytogenes and B.abortus antibodies among age groups (p>0.05). In this study, for the first time in cattle in the region of Adana serological methods revealed the presence L. monocytogenes, toxoplasmosis and listeriosis were higher than brucellosis seropositivity. Moreover, the prevalence of these diseases in the same animal at the highest rate was determined for T. gondii and L. monocytogenes.

Sentinel node assessment for diagnosis of groin lymph node involvement in vulval cancer.

Vulval cancer is usually treated by wide local excision with removal of groin lymph nodes (inguinofemoral lymphadenectomy) from one or both sides, depending on the tumour location. However, this procedure is associated with significant morbidity. As lymph node metastasis occurs in about 30% of women with early vulval cancer, accurate prediction of lymph node metastases could reduce the extent of surgery in many women, thereby reducing morbidity. Sentinel node assessment is a diagnostic technique that uses traceable agents to identify the spread of cancer cells to the lymph nodes draining affected tissue. Once the sentinel nodes are identified, they are removed and submitted to histological examination. This technique has been found to be useful in diagnosing the nodal involvement of other types of tumours. Sentinel node assessment in vulval cancer has been evaluated with various tracing agents. It is unclear which tracing agent or combination of agents is most accurate. To assess the diagnostic test accuracy of various techniques using traceable agents for sentinel lymph node assessment to diagnose groin lymph node metastasis in women with FIGO stage IB or higher vulval cancer and to investigate sources of heterogeneity. We searched MEDLINE (1946 to February 2013), EMBASE (1974 to March 2013) and the relevant Cochrane trial registers. Studies that evaluated the diagnostic accuracy of traceable agents for sentinel node assessment (involving the identification of a sentinel node plus histological examination) compared with histological examination of removed groin lymph nodes following complete inguinofemoral lymphadenectomy (IFL) in women with vulval cancer, provided there were sufficient data for the construction of two-by-two tables. Two authors (TAL, AP) independently screened titles and abstracts for relevance, classified studies for inclusion/exclusion and extracted data. We assessed the methodological quality of studies using the QUADAS-2 tool. We used univariate meta-analytical methods to estimate pooled sensitivity estimates. We included 34 studies evaluating 1614 women and approximately 2396 groins. The overall methodological quality of included studies was moderate. The studies included in this review used the following traceable techniques to identify sentinel nodes in their participants: blue dye only (three studies), technetium only (eight studies), blue dye plus technetium combined (combined tests; 13 studies) and various inconsistent combinations of these three techniques (mixed tests; 10 studies). For studies of mixed tests, we obtained separate test data where possible.Most studies used haematoxylin and eosin (H&E) stains for the histological examination. Additionally an immunohistochemical (IHC) stain with and without ultrastaging was employed by 14 and eight studies, respectively. One study used reverse transcriptase polymerase chain reaction analysis (CA9 RT-PCR), whilst three studies did not describe the histological methods used.The pooled sensitivity estimate for studies using blue dye only was 0.94 (68 women; 95% confidence interval (CI) 0.69 to 0.99), for mixed tests was 0.91 (679 women; 95% CI 0.71 to 0.98), for technetium only was 0.93 (149 women; 95% CI 0.89 to 0.96) and for combined tests was 0.95 (390 women; 95% CI 0.89 to 0.97). Negative predictive values (NPVs) for all index tests were > 95%. Most studies also reported sentinel node detection rates (the ability of the test to identify a sentinel node) of the index test. The mean detection rate for blue dye alone was 82%, compared with 95%, 96% and 98% for mixed tests, technetium only and combined tests, respectively. We estimated the clinical consequences of the various tests for 100 women undergoing the sentinel node procedure, assuming the prevalence of groin metastases to be 30%. For the combined or technetium only tests, one and two women with groin metastases might be 'missed', respectively (95% CI 1 to 3); and for mixed tests, three women with groin metastases might be 'missed' (95% CI 1 to 9). The wide CIs associated with the pooled sensitivity estimates for blue dye and mixed tests increased the potential for these tests to 'miss' women with groin metastases. There is little difference in diagnostic test accuracy between the technetium and combined tests. The combined test may reduce the number of women with 'missed' groin node metastases compared with technetium only. Blue dye alone may be associated with more 'missed' cases compared with tests using technetium. Sentinel node assessment with technetium-based tests will reduce the need for IFL by 70% in women with early vulval cancer. It is not yet clear how the survival of women with negative sentinel nodes compares to those undergoing standard surgery (IFL). A randomised controlled trial of sentinel node dissection and IFL has methodological and ethical issues, therefore more observational data on the survival of women with early vulval cancer are needed.

A new method using xenogeneicacellular dermal matrix in the reconstruction of lacrimal drainage

AimsTo prospectively evaluate the reliability and efficacy of a new treatment for the reconstruction of the lacrimal duct using a new histo-engineered material, xenogeneic (bovine) acellular dermal matrix.MethodFive patients (five...

A study of middle ear reconstruction, the degree of functional restoration and causes of graft failure following chronic ear disease

Aims and objectivesTo determine the results of various types of tympano-ossiculoplasties and the degree of functional restoration following surgery. Materials and methodsThis prospective study comprises 51 consecutive patients with chronic suppurative otitis media (CSOM) – tubotympanic disease (TTD) and atticoantral disease (AAD), who presented to the academic department of Otorhinolaryngology – Head & Neck Surgery, in a tertiary care hospital in South India. All patients underwent a thorough examination and appropriate investigations. Eustachian tube function (ETF) was assessed preoperatively by methylene blue dye test and saccharin test. The size of the mastoids was measured by using a graph paper, on which the X-ray film of the mastoid taken in the lateral oblique view (Law’s view) was superimposed. Patients with CSOM (TTD) with less than 3months of dry ear and small size mastoids on X-ray were subjected to cortical mastoidectomy and type I tympanoplasty; whereas patients with dry ear more than 3months underwent type I tympanoplasty alone. Type III tympanoplasty was carried out in those with erosion of incus/malleus by placing temporalis fascia over the stapes superstructure. Patients with AAD underwent modified radical mastoidectomy (MRM) and ossicular reconstruction was carried out depending on the remnant of the ossicles. Partial Ossicular Replacement Prosthesis (PORP) made of plastipore was used for Austin’s type b ossiculoplasty; while Plastipore/Gold was used as Total Ossicular Replacement Prosthesis (TORP) in type d ossiculoplasty. Patients were reviewed after 15days, 1 and 3months post-operatively for a clinico-audiological assessment of the operated ear to evaluate the graft status and hearing improvement. The postoperative audiograms were recorded on the 2nd and 3rd visit. Results and observationsOf the 51 patients with CSOM; 37 had TTD and 14 had AAD. Of the 37 patients with TTD, 35 patients had normal ETF and 2 of them had partial dysfunction. With normal ETF, the graft uptake rate was 80% compared to partial ETF which had only 50%. Patients with large and medium size mastoids had 89% of graft uptake. Patients with small and medium size perforations had 100% graft uptake; whereas large and subtotal perforations had 75% and 71.43% respectively. A total number of 34 tympanoplasties and 17 ossiculoplasties were done. Of these; 29 were type I and 5 were of type III. Out of 17 ossiculoplasties, 3 were type b and 14 cases were of type d. We used 7 Gold and 7 Plastipore TORP for the type d ossiculoplasty and PORP in 3 of the cases. Using temporal fascia as graft material 34 patients underwent tympanoplasty in whom the graft uptake was 79.41%, while 17 patients underwent ossiculoplasty using temporalis fascia as graft, the graft uptake was 88.23%. Tympanoplasty done for small and medium size perforations had 100% hearing improvement with A–B gap <20dB but patients who had large or subtotal perforations had 80% and 67% respectively. Hearing improvement to an A–B gap <20dB was noted in 91% and 60% following type I and type III tympanoplasty respectively. Hearing improvement to an A–B gap <20dB was noted in all the cases of type b ossiculoplasty and with type d ossiculoplasty (42%). ConclusionPatients with normal Eustachian tube function, large and medium size mastoids, small and medium size perforations of the tympanic membrane would have a good rate of graft uptake with tympano-ossiculoplasties thereby returning to normal hearing postoperatively.

Placental Alpha-Microglobulin-1 and Combined Traditional Diagnostic Test

OBJECTIVE: To evaluate whether the placental alpha-microglobulin-1 test (PAMG-1) compared with the combined traditional diagnostic test of pooling, nitrazine, and ferning (CTDT) would be a cost-beneficial screening strategy in the setting of potential preterm premature rupture of membranes (PROM). METHODS: A decision analysis model was constructed to estimate the cost benefit of PAMG-1 compared with CTDT on preterm delivery costs from a societal perspective. Our primary outcome was the net cost benefit per person tested in the setting of potential preterm PROM at 34 to less than 37 weeks of gestation. Baseline probabilities and cost assumptions were derived from published literature. We conducted sensitivity analyses. Cost estimates reflect 2013 U.S. dollars. RESULTS: The estimated annual net benefit from PAMG-1 was $12,215 per person tested, whereas CTDT had a net benefit of $4,737 per person tested. If the probability of rupture is less than 42%, PAMG-1 will be cost-beneficial, with a net savings of $5,000–32,000 per person tested, whereas CTDT will have a net savings of $5,000–9,000 per person tested. If the probability of rupture is greater than 44%, PAMG-1 will not generate any net savings. In equivocal cases of CTDT, admission for dye test is cost-beneficial over PAMG-1 or ultrasonography for amniotic fluid index. Sensitivity analyses were robust. Preterm delivery cost, specificity, and the probability of a positive PAMG-1 result were the main drivers of the results. CONCLUSION: PAMG-1 is the most optimal diagnostic method both economically and clinically in diagnosing preterm PROM in uncertain presentations and when CTDT is equivocal or inconclusive.

Laparoscopic Evaluation of the Tuboperitoneal Factors in Infertility

Objective: The aim of the study is to describe the tuboperitoneal findings in selected infertile patients by laparoscopy. Methods and Materials: This cross-sectional study was carried out at the infertility center in BIRDEM during the period of September 2002 to February 2003. A total of 50 patients were selected for laparoscopy and dye test. Those patients who had medical disorder and contraindications for laparoscopy were excluded from the study. Patients with infertility due to male factors were also excluded from this study. Laparoscopy was scheduled in secretory phase of menstruation. Results: Among the study population, 35 (70%) patients were primary infertile group while 15 (30%) patients were secondary infertile group. According to age distribution, 20 (57%) patients of primary infertility and 8 (53%) patients of secondary infertility belonged to age group 25-30 years. Duration of infertility was between 2 yrs to 5 yrs in 45% of patient where 30% cases had been infertile for 5 yrs to 10 yrs. Laparoscopy revealed normal findings in 14 (28%) patients and ovarian cause like chocolate cyst and polycystic ovary in 21 (42%). Peritoneal pathology like adhesion or endometriosis was detected in 19 (38%) cases. Bilateral tubal occlusion was found in 4 (8%) cases and unilateral tubal occlusion in 7 (14%) cases. Conclusion: Laparoscopy is a necessary diagnostic tool for evaluation of tubo-peritoneal pathology in infertile women. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18546 Birdem Med J 2014; 4(1): 9-12

Comparison of placental alpha microglobulin-1 in vaginal fluid with intra-amniotic injection of indigo carmine for the diagnosis of rupture of membranes

The purpose of this study was to compare the diagnostic performance of an immunoassay for placental alpha microglobulin-1 (PAMG-1) in vaginal fluid with the intra-amniotic instillation of indigo carmine for the diagnosis of membrane rupture in patients with an equivocal status. A prospective multi-site study was performed involving women reporting signs, symptoms, or complaints suggestive of rupture of membrane (ROM) between 21 and 42 weeks of gestation without obvious leakage of fluid from the cervical os during sterile speculum examination and without confirmation of ROM by traditional methods. A total of 140 patients were recruited with a prevalence of ROM of 19.3%. The PAMG-1 test had a sensitivity of 100.0% [confidence interval (CI) 0.87-1.0], specificity of 99.1% [(CI) 0.95-0.99], positive predictive value of 96.3% [(CI) 0.82-0.99], negative predictive value of 100.0% [(CI) 0.97-1.0], and ± likelihood ratios of 74.6 [(CI) 20.31-274.51] and 0.0 [(CI) 0.00-0.98]. The PAMG-1 immunoassay in vaginal fluid yielded results that were comparable to those of the instillation of indigo carmine into the amniotic cavity; therefore, we propose that PAMG-1 is a sensitive and specific test to assess ROM in patients with an equivocal diagnosis based on simple tests. This finding prompts consideration for the use of the noninvasive PAMG-1 test in situations where the use of the invasive dye test is not practical.