Efficacy Of Different Devices Research Articles

(111) Penile Constriction Device Satisfaction: Does Sexual Preference Have Any Effect on Preferences and Effectiveness?

Abstract Introduction Penile constriction devices are a noninvasive way to improve sexual performance and erectile function, making them an appealing choice for men. To understand their clinical value and patient satisfaction, it is important to assess patient preferences and the efficacy of different devices. Comparative studies between heterosexual and homosexual men are also necessary to recognize and meet the diverse needs and experiences of these populations, leading to more tailored and effective recommendations. Objective To assess and compare the preference and effectiveness of two medical-grade penile constriction devices between heterosexual and homosexual men. Methods Between May 2023 and July 2023, males were recruited via social media platforms and prospectively enrolled into an IRB-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men (SHIM) and Androgen Deficiency in Aging Males (ADAM). Participants were then randomized to which device (FirmTech vs by Giddy) they would receive first and were instructed to use the device twice either during masturbation or intercourse within a two-week timeframe. Once utilized, the participants completed a 17-question, five-point Likert scale device satisfaction questionnaire. Once the first device and survey were completed the other device was sent and the process was repeated. In the device satisfaction questionnaire, lower numbers indicated more positive responses to the questions. We then took the data collected and matched 2 homosexual participants to 1 heterosexual participant by age. Responses from the questionnaire with numerical values are presented as the mean difference (MD) and analyzed using a paired t-test. Questionnaire responses that were “yes” or “no” were analyzed using McNemar’s chi-square analysis. A p-value less than 0.05 was considered significant. Results Fifty men were enrolled and 44 completed the study. After matching the patients by age, 21 were included in the analysis. Among the 21 participants, 14 (66.7%) were homosexual and 7 (33.3%) heterosexual. There was no statistically significant preference or effectiveness amongst the heterosexual group for either device. However when comparing both devices within the homosexual group, 11 (78.6%)) would recommend the FirmTech to a friend, compared to 5 (35.7%) who would recommend the Eddie by Giddy device (p=0.0412). Within the homosexual group, they preferred the ease of putting on the device while flaccid and erect and its comfort (MDs -1.14, -1.79, and-1.50; respective p-values 0.0019, 0.0010, and 0.0160). Homosexual participants also had a significantly better overall impression of the FirmTech device (MD=-0.79; p=0.0099). Lastly, the homosexual participants were significantly more likely to use the FirmTech device in partnered sex as compared to the Giddy (MD=-01.36, p=0.0038). Conclusions These findings suggest that homosexual men favor the FirmTech device over the Eddie by Giddy, rating it more positively and being more likely to recommend it to a friend. Further research with a larger and more diverse sample is needed to fully comprehend the different preferences and satisfaction with penile constriction devices among men with different sexual orientations. Disclosure Yes, this is sponsored by industry/sponsor: FirmTech Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech.

A comparative analysis of intravenous infusion methods for low-resource environments.

Intravenous (IV) therapy is a crucial aspect of care for the critically ill patient. Barriers to IV infusion pumps in low-resource settings include high costs, lack of access to electricity, and insufficient technical support. Inaccuracy of traditional drop-counting practices places patients at risk. By conducting a comparative assessment of IV infusion methods, we analyzed the efficacy of different devices and identified one that most effectively bridges the gap between accuracy, cost, and electricity reliance in low-resource environments. In this prospective mixed methods study, nurses, residents, and medical students used drop counting, a manual flow regulator, an infusion pump, a DripAssist, and a DripAssist with manual flow regulator to collect normal saline at goal rates of 240, 120, and 60 mL/h. Participants' station setup time was recorded, and the amount of fluid collected in 10 min was recorded (in milliliters). Participants then filled out a post-trial survey to rate each method (on a scale of 1 to 5) in terms of understandability, time consumption, and operability. Cost-effectiveness for use in low-resource settings was also evaluated. The manual flow regulator had the fastest setup time, was the most cost effective, and was rated as the least time consuming to use and the easiest to understand and operate. In contrast, the combination of the DripAssist and manual flow regulator was the most time consuming to use and the hardest to understand and operate. The manual flow regulator alone was the least time consuming and easiest to operate. The DripAssist/Manual flow regulator combination increases accuracy, but this combination was the most difficult to operate. In addition, the manual flow regulator was the most cost-effective. Healthcare providers can adapt these devices to their practice environments and improve the safety of rate-sensitive IV medications without significant strain on electricity, time, or personnel resources.

(367) Penile Constriction Device Satisfaction: Does Sexual Preference Have Any Effect on Preferences and Effectiveness?

Abstract Introduction Penile constriction devices are a noninvasive way to improve sexual performance and erectile function, making them an appealing choice for men. To understand their clinical value and patient satisfaction, it is important to assess patient preferences and the efficacy of different devices. Comparative studies between heterosexual and homosexual men are also necessary to recognize and meet the diverse needs and experiences of these populations, leading to more tailored and effective recommendations. Objective To assess and compare the preference and effectiveness of two medical-grade penile constriction devices between heterosexual and homosexual men. Methods Between May 2023 and July 2023, males were recruited via social media platforms and prospectively enrolled into an IRB-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men (SHIM) and Androgen Deficiency in Aging Males (ADAM). Participants were then randomized to which device (FirmTech vs Eddie by Giddy) they would receive first and were instructed to use the device twice either during masturbation or intercourse within a two-week timeframe. Once utilized, the participants completed a 17-question, five-point Likert scale device satisfaction questionnaire. Once the first device and survey were completed the other device was sent and the process was repeated. In the device satisfaction questionnaire, lower numbers indicated more positive responses to the questions. We then took the data collected and matched 2 homosexual participants to 1 heterosexual participant by age. Responses from the questionnaire with numerical values are presented as the mean difference (MD) and analyzed using a paired t-test. Questionnaire responses that were “yes” or “no” were analyzed using McNemar’s chi-square analysis. A p-value less than 0.05 was considered significant. Results Fifty men were enrolled and 44 completed the study. After matching the patients by age, 21 were included in the analysis. Among the 21 participants, 14 (66.7%) were homosexual and 7 (33.3%) heterosexual. There was no statistically significant preference or effectiveness amongst the heterosexual group for either device. However when comparing both devices within the homosexual group, 11 (78.6%)) would recommend the FirmTech to a friend, compared to 5 (35.7%) who would recommend the Eddie by Giddy device (p=0.0412). Within the homosexual group, they preferred the ease of putting on the device while flaccid and erect and its comfort (MDs -1.14, -1.79, and-1.50; respective p-values 0.0019, 0.0010, and 0.0160). Homosexual participants also had a significantly better overall impression of the FirmTech device (MD=-0.79; p=0.0099). Lastly, the homosexual participants were significantly more likely to use the FirmTech device in partnered sex as compared to the Giddy (MD=-01.36, p=0.0038). Conclusions These findings suggest that homosexual men favor the FirmTech device over the Eddie by Giddy, rating it more positively and being more likely to recommend it to a friend. Further research with a larger and more diverse sample is needed to fully comprehend the different preferences and satisfaction with penile constriction devices among men with different sexual orientations Disclosure Yes, this is sponsored by industry/sponsor: FirmTech and Eddie by Giddy Clarification: Industry funding only - investigator initiated and executed study Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech- On Scientific Review Board.

(135) A Randomized Survey Study Comparing the Preference and Effectiveness of Two Different Penile Constriction Devices

Abstract Introduction Penile constriction devices are a noninvasive way to improve sexual performance and erectile function, making them an appealing choice for men. To understand their clinical value and patient satisfaction, it is important to assess patient preferences and the efficacy of different devices. Comparative studies between heterosexual and homosexual men are also necessary to recognize and meet the diverse needs and experiences of these populations, leading to more tailored and effective recommendations. Objective To assess and compare the preference and effectiveness of two medical-grade penile constriction devices. Methods Between May 2023 and July 2023, males were recruited via social media platforms and prospectively enrolled into an IRB-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men (SHIM) and Androgen Deficiency in Aging Males (ADAM). Participants were then randomized to which device (FirmTech vs Eddie by Giddy) they would receive first and were instructed to use the device twice either during masturbation or intercourse within a two-week timeframe. Once utilized, the participants completed a 17-question, five-point Likert scale device satisfaction questionnaire. Once the first device and survey were completed, the other device was sent and the process was repeated. In the device satisfaction questionnaire, lower numbers indicated more positive responses to the questions. Responses from the questionnaire with numerical values are presented as the mean difference (MD) and analyzed using a paired t-test. Questionnaire responses that were “yes” or “no” were analyzed using McNemar’s chi-square analysis. A p-value less than 0.05 was considered significant. Results Fifty men were enrolled and 44 completed the study. Among the participants, 31 (70.4%) identified as homosexual, 10 (22.7%) as heterosexual, and 3 (6.8%) as bisexual with a mean age of 36.5 (IQR = 16.5). Table 1 provides a summary of the demographic characteristics. The baseline mean SHIM and ADAM score was 19.5 and 0.5, respectively. A statistically significant preference for the ease of putting on the FirmTech device while erect was found (MD,-0.84; p = 0.001). There was also a statistically significant preference for the comfort, adjustability, and stretch of the FirmTech device (MDs -0.66, -0.32, and -0.86; respective p values 0.018, 0.033, and <0.001). Finally, 35 (79.5%) participants stated that they would recommend FirmTech to a friend, as opposed to 25 (55.6%) who would recommend Eddie by Giddy (p = 0.020). Conclusions These findings suggest that, when comparing penile constriction devices, men prefer the FirmTech device over the Eddie by Giddy with respect to ease of putting on the device, comfort, stretch, and adjustability. Men are more likely to recommend the FirmTech device over Eddie by Giddy. Further research with a larger sample size, which includes a more equal distribution of men of different sexual orientations, is warranted to further support the generalizability and validity of these initial findings, illustrate consumer preference for FirmTech, and expound upon its preferential qualities. Disclosure Yes, this is sponsored by industry/sponsor: FirmTech and Eddie by Giddy. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech- On Scientific Review Board.

Application of Transesophageal Echocardiography in Amplatzer Atrial Septal Defect Occluder for Percutaneous Closure of Large Patent Foramen Ovale.

Objective The Amplatzer patent foramen ovale (PFO) occluder is the most commonly used device for percutaneous closure of a large PFO. However, its use may predispose the patient to postoperative residual shunting. To reduce the incidence of residual shunting, we investigated the safety and effectiveness of the Amplatzer atrial septal defect (ASD) occluder for percutaneous closure of a large PFO measured by transesophageal echocardiography (TEE) and evaluated the value of TEE in this procedure. Methods Overall, 118 patients who were diagnosed with a large PFO (all with a ≥ 2 mm left atrial side height after the Valsalva maneuver (VM) excluding those with a small ASD) using contrast transthoracic echocardiography (c-TTE) and TEE underwent closure under TEE guidance at The First Affiliated Hospital of Xi'an Jiaotong University. An ASD device was used in 48 patients (group I) and a PFO device in 70 (group II). After the procedure, we verified the safety and efficacy of different devices using c-TTE, TTE, and TEE. Results In both groups, the preoperative TEE results showed a significantly increased left height of the PFO after VM compared with that at rest (all P < 0.01). Compared with the left height of the PFO measured using TEE after VM, the PFO-stretch diameter (SD) measured by TEE after the delivery sheath passed the PFO was higher (all P < 0.01). We selected the ASD occluder size according to this PFO-SD. In group II, most patients underwent the implantation of the larger PFO devices. Interventional treatment was successfully performed on all patients. The effective occlusion rate in group I at 12 months after the procedure was significantly higher than that in group II (93.7% vs. 78.6%, P < 0.05). The TEE results showed that 18 patients with a medium and large residual shunt at 12 months after the procedure exhibited an intradisc tunnel-like shunt. Conclusion The Amplatzer ASD device and Amplatzer PFO device are safe for large PFO closure, but the Amplatzer ASD device has a higher effective occlusion rate. TEE plays a crucial role in the use of the Amplatzer ASD occluder for percutaneous closure of a large PFO.

Assessing the Efficacy of Four Diagnostic Devices and Four Nomograms in Posterior Chamber Phakic Intraocular Lens Size Selection.

To assess the efficacy of different devices and nomograms in predicting the most optimal Implantable Collamer Lens (ICL) (STAAR Surgical) size. This retrospective study includes 73 patients (142 eyes) who underwent ICL placement surgery. Anterior segment measurements were obtained by the OPD-Scan III (Marco), the Lenstar LS 900 (Haag-Streit AG/Alcon Laboratories, Inc), the Galilei G4 (Ziemer), and the VuMax ultrasound biomicroscopy device (UBM) (Sonomed Escalon). The efficacy of the four devices and four nomograms was assessed by comparing the indicated ICL sizes to the patient's postoperative vault measurements. Using white-to-white (WTW) measurements obtained by the Lenstar LS 900 and Galilei G4 coupled with the U.S. Food and Drug Administration's (FDA) (also called the manufacturer's) nomogram predicted the highest percentage (33% and 43%) of the 13.7 mm ICL sizes, respectively. Using the VuMax UBM coupled with the Dougherty nomogram indicated the highest percentage (80%) of the 12.6 mm ICL size. The ICL sizes predicted by UBM using the Parkhurst nomogram were comparable to those deemed ideal according to postoperative vault measurements. The Parkhurst nomogram predicted the most appropriate ICL size. When using WTW measurements, the optimized WTW nomogram showed promising results, especially in eyes whose preoperative calculations suggest low postoperative vaults. Moreover, clinicians should use caution when using the FDA nomogram because it showed a propensity toward indicating oversized ICLs. [J Refract Surg. 2022;38(2):106-111.].

Comparison of digital image displays performance in the detection of artificial internal root resorptions lesions.

To compare the diagnostic efficacy of different devices for visualizing digital images in detecting simulated internal root resorption (IRR). 26 uniradicular human teeth were sectioned along its long axis and randomly divided into two groups. Then, they were submerged in hydrochloric acid (HCl) P.A 37% at different times to make two types of defects: Type 1 (2 hours), and type 2 (3 hours). Digital periapical radiographs were acquired in three moments: before section, after section and after immersion in acid. The images were evaluated on three different devices: 27-inch iMac Desktop, 8-inch Android Tablet, and 5.5-inch iPhone 8 Plus using a 5-point scale. The sensitivity and accuracy values were higher with the use of the Android Tablet, for both types of defects. For the values of the area under ROC curve, higher results were observed with the Android Tablet and lower results with the iMac, showing a significant difference (p < 0.05) when comparing the use of the iMac with the Android Tablet and iPhone 8, for type 1 defects. When comparing the different devices, in the evaluation of images of type 2 defects, the values showed no statistical difference, regardless of the device evaluated (p > 0.05). The size of the lesion interferes with the detection capacity in the image. However, the use of portable devices does not impair the diagnosis of IRR, regardless of size and the dental practioners may use different devices/display, under optimal viewing conditions, to detect IRR lesions, without jeopardizing the diagnostic ability.

Preliminary Study on the Efficacy of Peritoneal Patch in Reducing the Incidence of Pancreatic Fistula after Pancreaticoduodenectomy

Introduction: Several studies have already evaluated the efficacy of different devices in decreasing the incidence of POPF by reinforcing the pancreatic anastomosis after pancreaticoduodenectomy. Unfortunately, until now none of them have shown any clear benefits. Purpose: To evaluate a new technique to perform a pancreaticojejunostomy in pancreas at high risk for fistula. Method: From June 2020, a total of 10 patients out of 33 who underwent a pancreaticoduodenectomy for cancer at our institution were selected for this study. All of the selected patients were at high risk for pancreatic fistula due to soft pancreatic parenchyma and/or non dilated pancreatic duct. A pancreaticojejunostomy with Blumgart’s technique was performed in every case. A peritoneal patch was used to cover the surface of the pancreatic stump before the anastomosis in order to give a sealing effect and strengthen the suture. A pancreatic stent was always placed through the pancreatic duct. We assessed the rate of POPF (ISGPF definition) within 30 postoperative days. Results: In those patients treated by the use of a peritoneal patch no fistula was observed. All patients underwent a pre-discharge CT-scan at day 7 showing no abdominal collections or vascular pseudo-aneurysms. The peritoneal patch might improve the anastomosis healing by lowering the outflow of pancreatic juice from the parenchyma during the immediate post-operative days. Conclusion: Preliminary data about the application of a peritoneal patch are encouraging and it might prove a useful tool in preventing POPF and PPH.

Mechanical circulatory support for Takotsubo syndrome: a systematic review and meta-analysis

BackgroundCardiogenic shock occurs in 10%–15% of patients with Takotsubo syndrome (TS). For several reasons catecholamines, and especially inotropes, should be avoided in TS. Temporary mechanical circulatory support (MCS) appears attractive as bridge-to-recovery, but prospective studies are lacking. Here we analyze the available literature on MCS use in patients with TS. Methods and resultsPubMed/Medline was systematically screened until December 2019. 18 studies reporting pooled data of 5629 TS patients, of whom 227 had received MCS, were considered for a qualitative synthesis. 81 articles from 2003 through 2019 reporting individual data of 93 MCS cases were included in a meta-analysis. Median age was 57 (IQR: 43–68) years, 83.9% were women, and a physical trigger could be identified in 74.1% of cases. Median left ventricular ejection fraction (LVEF) before MCS was 20% (IQR: 15–25) and comparable between groups defined by MCS device. An apical TS type was present in 76.1% of cases. The overall number of publications on MCS for TS increased over time, as did those using veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella, while those using intra-aortic balloon pump declined. MCS-related complications were not regularly reported. Median time on MCS was 3 (IQR: 2–7) days, with an overall survival of 94.6%. ConclusionsMCS for TS-related shock is increasingly reported, with a growing use of V-A ECMO and Impella. Currently available clinical data support this approach. Prospective studies are needed to evaluate safety and efficacy of different devices as well as timing of MCS in this special patient population.

Compared Abilities of Endoscopic Techniques to Increase Colon Adenoma Detection Rates: A Network Meta-analysis

Adenoma detection rate (ADR) is a quality metric for colorectal cancer screening. We performed a systematic review and network meta-analysis to assess the overall and comparative efficacies of different endoscopic techniques in adenoma detection. We performed a systematic review of published articles and abstracts, through March 15, 2018, to identify randomized controlled trials of adults undergoing colonoscopy that compared the efficacy of different devices in detection of adenomas. Our final analysis included 74 2-arm trials that comprised 44948 patients. These studies compared efficacies of add-on devices (cap, endocuff, endo-rings, G-EYE), enhanced imaging techniques (chromoendoscopy, narrow-band imaging, flexible spectral imaging color enhancement, blue laser imaging), new scopes (full-spectrum endoscopy, extra-wide-angle-view colonoscopy, dual focus), and low-cost optimizing existing resources (water-aided colonoscopy, second observer, dynamic position change), alone or in combination with high-definition colonoscopy or each other. Primary outcome was increase in ADR. We performed pairwise and network meta-analyses, and appraised quality of evidence using GRADE. Low-cost optimizing existing resources (odds ratio [OR], 1.29; 95% CI,1.17-1.43), enhanced imaging techniques (OR,1.21; 95% CI, 1.09-1.35), and add-on devices (OR,1.18; 95% CI, 1.07-1.29) were associated with a moderate increase in ADR compared with high-definition colonoscopy; there was low to moderate confidence in estimates. Use of newer scopes was not associated with significant increases in ADR compared with high-definition colonoscopy (OR, 0.98; 95% CI, 0.79-1.21). In our comparative efficacy analysis, no specific technology for increasing ADR was superior to others. We did not find significant differences between technologies in detection of advanced ADR, polyp detection rate, or mean number of adenomas/patient. In a network meta-analysis of published trials, we found that low-cost optimization of existing resources to be as effective as enhanced endoscopic imaging, or add-on devices, in increasing ADR during high-definition colonoscopy.

Safety and efficacy of Cardi-O-fix occluder for percutaneous closure of a patent foramen ovale

Background:Amplatzer occluder and Cardio-O-fix occluder are currently used in percutaneous closure of patent foramen ovale. However, there is still a lack of relevant reports comparison the differences between them. The aim of this study was to evaluate the short-term and mid-term safety and efficacy of the Cardi-O-fix occluder in preventing recurrent cerebrovascular events in patients with a patent foramen ovale (PFO).Methods:We enrolled 246 patients (105 men) with a PFO from May 30, 2013 to March 30, 2015 in this single-center prospective study. All patients were treated by PFO interventional closure, with the Cardi-O-fix PFO occluder being used in 180 patients and the Amplatzer PFO occluder being utilized in the remaining 66 patients. After the procedure, we verified the safety and efficacy of different devices using contrast transthoracic echocardiography.Results:Neither recurrent stroke nor death was encountered during the follow-up of 12 months. Transient ischemic attack (TIA) was noted in 2 patients (1.1%) in the Cardi-O-fix PFO occluder group, and 1 patient suffered from TIA (1.5%) in the Amplatzer PFO occluder group. Among them, only 1 patient exhibited a small right to left shunt (RLS). There was no statistical difference in recurrent cerebral ischemic events. Three cases of paroxysmal atrial fibrillation were observed in the Cardi-O-fix PFO occluder group. One reverted spontaneously to sinus rhythm and the other 2 cases had pharmacologic conversion to sinus rhythm. One case of paroxysmal atrial fibrillation occurred in the Amplatzer group, which underwent pharmacologic conversion to sinus rhythm. There was no significant difference between the 2 groups regarding incidence of arrhythmia. No occluder translocation, erosion, pericardial effusion, and puncture site bleeding were observed in the 2 groups within 12 months of follow-up. The complete closure rates of the Cardi-O-fix and Amplatzer PFO occluder devices at the 12 months after the procedure were 73.9% and 63.6%, respectively, and the effective closure rates were 90.6% and 86.4%, respectively. There was no statistically significant difference in the complete closure rate and effective occlusion rate (P > 0.05) between the devices.Conclusions:There was no significant difference in the short- and mid-term efficacy and safety between the Cardi-O-fix PFO occluder and Amplatzer PFO occluder. The efficacy and safety of the Cardi-O-fix occluder were comparable to those of the Amplatzer PFO occluder.

Hearing Instruments for Unilateral Severe-to-Profound Sensorineural Hearing Loss in Adults: A Systematic Review and Meta-Analysis

Objectives:A systematic review of the literature and meta-analysis was conducted to assess the nature and quality of the evidence for the use of hearing instruments in adults with a unilateral severe to profound sensorineural hearing loss.Design:The PubMed, EMBASE, MEDLINE, Cochrane, CINAHL, and DARE databases were searched with no restrictions on language. The search included articles from the start of each database until February 11, 2015. Studies were included that (a) assessed the impact of any form of hearing instrument, including devices that reroute signals between the ears or restore aspects of hearing to a deaf ear, in adults with a sensorineural severe to profound loss in one ear and normal or near-normal hearing in the other ear; (b) compared different devices or compared a device with placebo or the unaided condition; (c) measured outcomes in terms of speech perception, spatial listening, or quality of life; (d) were prospective controlled or observational studies. Studies that met prospectively defined criteria were subjected to random effects meta-analyses.Results:Twenty-seven studies reported in 30 articles were included. The evidence was graded as low-to-moderate quality having been obtained primarily from observational before-after comparisons. The meta-analysis identified statistically significant benefits to speech perception in noise for devices that rerouted the speech signals of interest from the worse ear to the better ear using either air or bone conduction (mean benefit, 2.5 dB). However, these devices also degraded speech understanding significantly and to a similar extent (mean deficit, 3.1 dB) when noise was rerouted to the better ear. Data on the effects of cochlear implantation on speech perception could not be pooled as the prospectively defined criteria for meta-analysis were not met. Inconsistency in the assessment of outcomes relating to sound localization also precluded the synthesis of evidence across studies. Evidence for the relative efficacy of different devices was sparse but a statistically significant advantage was observed for rerouting speech signals using abutment-mounted bone conduction devices when compared with outcomes after preoperative trials of air conduction devices when speech and noise were colocated (mean benefit, 1.5 dB). Patients reported significant improvements in hearing-related quality of life with both rerouting devices and following cochlear implantation. Only two studies measured health-related quality of life and findings were inconclusive.Conclusions:Devices that reroute sounds from an ear with a severe to profound hearing loss to an ear with minimal hearing loss may improve speech perception in noise when signals of interest are located toward the impaired ear. However, the same device may also degrade speech perception as all signals are rerouted indiscriminately, including noise. Although the restoration of functional hearing in both ears through cochlear implantation could be expected to provide benefits to speech perception, the inability to synthesize evidence across existing studies means that such a conclusion cannot yet be made. For the same reason, it remains unclear whether cochlear implantation can improve the ability to localize sounds despite restoring bilateral input. Prospective controlled studies that measure outcomes consistently and control for selection and observation biases are required to improve the quality of the evidence for the provision of hearing instruments to patients with unilateral deafness and to support any future recommendations for the clinical management of these patients.

Efficacy of different devices in removing calcium hydroxide from the root canal

Objectives: The aim was to compare the efficiency of removing calcium hydroxide (CH) with different devices and irrigants. Materials and Methods: Ten roots were served as positive and negative controls, the remaining roots (n=75) were assigned into 5 respect to the removal techniques: Group (G) I, Master apical file- manual needle irrigation (MNI); GII, Canal Brush (CB)-MNI; GIII, RinsEndo; GIV, Self-adjusting file(SAF)-Vatea; GV, CB+MNI, followed by SAF+Vatea. The roots were grooved longitudinally and split into halves. Three specimens from each group were randomly selected to evaluate CH remnants under the SEM. A digital camera acquired images of each half of the canal. A scoring system was used to assess amount of residue. Data were analyzed using Kruskal–Wallis and Mann–Whitney U tests (p < 0.05). Results: Remnants of CH were found in all experimental groups. Examining the efficacy of CH removal from the each third of the canal showed that there was a statistically significant difference between the middle (p=0,003) and cervical (p=0,006) thirds. Conclusions: None of the techniques removed the CH medicament completely; the use of the RE and SAF facilitated removal of CH especially from the cervical third.

Clinical Study of Trans-catheter Closure of Patent Ductus Arteriosus with Occluder Devices among Children Aged 9 Months to 18 Years

Background and Objectives: This study was aimed at determining our experience with occluder devices over last 5 years. The objective of this study is to compare the complication rates and efficacy of different devices used for the closure of PDA. Methods: A cross-sectional retrospective study in which a review of the records of all children who had PDA surgery in a paediatric cardiac center, Innova Childrens’ Heart Hospital, Hyderabad, India over a five year period (June 2007 and July 2011) was undertaken. The hospital records showed that from June 2007 to July 2011, a total of 456 children aged 9 months to 18 years had trans-catheter closure over the study period, of Research Article International Journal of TROPICAL DISEASE & Health, 4(1): 31-44, 2014 32 these, 159 underwent trans-catheter device closure of PDA. A team of experienced paediatric cardiologist performed all the procedures. Results: Out of the 159 cases, 134 (84.2%) were successful while 25 (15.7%) were complicated. Five (5) {20.0%} cases had temporary residual leak, 3 (12.0%) had failure of the procedure that required surgical intervention, 9 (36.0%) had protrusion of the device into the aorta without significant Doppler pressure gradient. There exist a relation between success, complication and device used for the procedure.The type of occluder device used for the procedure significantly affect the outcome (χ = 16.37; p = 0.02) Chinese occlude devise had the highest success rate. Twenty five (25.0) {15.7%} patients had complications in all. The commonest complication (protrusion of the device into the aorta) was seen in 3 (1.8%) cases with Chinese duct occluder, 3(1.8%) with Sear Heart R and 3 (1.8%) cases with ADOs. Non died from the procedure. Conclusion: The commonest complication is (protrusion of the device into the aorta) with Chinese occludes devise showing the highest success rate. The learning curve and accumulating experience play an indispensable role in choosing the proper device and its size.

Catheter Closure of Atrial Septal Defects and Patent Foramen Ovale in Patients with an Atrial Septal Aneurysm Using Different Devices

Atrial septal aneurysm is frequently associated with patent foramen ovale (PFO) and atrial septal defects (ASD). Moreover, a relationship between atrial septal aneurysm and embolic cerebrovascular events has been suggested. The aims of this study were to analyze morphological and functional characteristics of atrial septal aneurysm in PFO and ASD patients and to assess the feasibility and efficacy of different devices for transcatheter closure and the influence of atrial septal aneurysm. Between March 1997 and May 2000 transcatheter ASD or PFO closure was attempted in 63 patients (mean age 47 +/- 13 years) with an atrial septal aneurysm using one of the following devices: Angelwings (n = 3), Cardioseal (n = 5), Cardioseal-Starflex (n = 7), Amplatzer (n = 11), Amplatzer-PFO (n = 5), PFO-Star (n = 25), or Helex (n = 7). Implantation was primarily successful (after the first or second attempt) in all patients. One PFO-Star device embolized 12 hours after the procedure. During follow-up (0.6-37 months, mean 10.4 +/- 9.2) a residual shunt could be detected by transesophageal echocardiography after 2 weeks in four patients and after 6 months in one patient. Three PFO patients had cerebrovascular events after implantation. Two patients had a transient ischemic attack (TIA) and one patient a stroke. A thrombus formation on the device detected in three patients disappeared after antithrombotic therapy. We conclude that ASDs and PFOs with an associated atrial septal aneurysm can be closed with different available devices. There seem to be no additional risks compared with patients without atrial septal aneurysm.