Patient Satisfaction Scores Research Articles

Sub-Tenon’s Block in Patients with Previous Encircling Band Surgery—A Feasibility Study

Introduction: During the COVID-19 pandemic, reducing aerosol-generating procedures became fundamental, particularly in ophthalmic surgeries traditionally performed under general anesthesia (GA). Regional anesthesia, such as sub-Tenon’s block (STB), is widely used in vitreoretinal surgeries, offering a safer alternative by avoiding airway manipulation. However, the altered orbital anatomy in patients with previous scleral explant surgery creates unique challenges to STB application. This study aims to evaluate the effectiveness, safety, and feasibility of STB in patients after encircling band surgery. Methods: This retrospective analysis included 46 patients with a history of scleral explant surgery, undergoing vitreoretinal procedures at the Bern University Hospital. All procedures were conducted under STB with either analgosedation or GA for additional support when required. An ophthalmic surgeon or an experienced anesthesiologist performed the STBs. Data collected included block success rate, procedural difficulty, incidence of chemosis, and patient satisfaction. The Institutional Ethics Committee approved this study, and all participants provided informed consent. Results: STB was successfully administered in 93.5% of cases, with only three unsuccessful blocks. Block placement was rated as easy in 55% of cases, moderately difficult in 28%, and difficult in 17%. Chemosis was observed in 24% of patients, with severe cases in only 4%. Patient satisfaction scores were high, with most patients expressing satisfaction with the STB procedure. Conversion to GA was required in only one case due to alcohol withdrawal-related agitation. Discussion: The high success rate and minimal complications suggest that STB is a feasible and safe alternative to GA in patients with prior scleral buckling surgery. The altered orbital anatomy presents potential challenges, including scar tissue and compartmentalization, which may lead to patchy anesthesia. However, the use of STB avoids the risks associated with GA and may be especially beneficial for elderly or frail patients. Future studies should further investigate the hemodynamic implications of STB in these cases and the potential for ultrasound-guided techniques to improve accuracy and safety.

Surgeon Age, Years in Practice, and Location of Training Are Associated With Patient Satisfaction.

Patient satisfaction is associated with communication-related measures, empathy, and meeting expectations. However, it is not clear what surgeon characteristics are associated with patient satisfaction. As such, the purpose of this study was to investigate the surgeon sociodemographic, training, and practice parameters that may be associated with patient satisfaction. A retrospective study of patient satisfaction scores was conducted from 7,856 patients who rated 62 orthopaedic surgeons in 2021 within a single hospital system. Three questions from the National Research Corporation survey were used to assess patient satisfaction. Bivariate analyses and multiple linear regression analyses were performed. For chi-square analyses, patient satisfaction scores were recoded into either above the mean or below/equal to the mean score. Overall, 57 male (91.9%) and five female orthopaedic surgeons (8.1%) participated. Mean age was 49.3 ± 9.9 years. Median years in practice was 14 years (range, 1 to 38 years). More years in practice was associated with lower patient satisfaction scores for careful listening (P = 0.048), likelihood to recommend the provider (P = 0.021), and total score (P = 0.029). Older surgeon age was associated with lower total scores (P = 0.039). Surgeons with 30 or more years of practice were more likely to be recommended (P = 0.030). Surgeons who trained in the Northeast for fellowship and/or residency were more likely to be recommended. Older surgeon age and training in the Northeast were associated with higher patient satisfaction. Older surgeon age and fellowship and/or residency training in the Northeast were associated with higher patient satisfaction, whereas 30 or more years of practice was associated with lower patient satisfaction. In bivariate analysis, female surgeons and foot and ankle training were associated with higher patient satisfaction, whereas spine surgeons had lower patient satisfaction scores. These findings suggest that patient-centered communication, patient-surgeon concordance, and appropriate help may improve patient satisfaction. Level IV.

Observation on the efficacy of cataract surgery combined with ICL implantation in the contralateral eye for patients with high myopia complicated with monocular cataract

Objective: To assess the surgical outcomes of cataract surgery combined with phakic posterior chamber intraocular lens (ICL) implantation in the contralateral eye for patients with high myopia and monocular cataract. Methods: This is a retrospective case series study. Clinical data were collected from 10 patients (20 eyes) with high myopia and monocular cataract who underwent phacoemulsification cataract extraction and intraocular lens implantation in the cataract eye (cataract surgery eye), and implantable Collamer lens (ICL) implantation in the contralateral eye (ICL implantation eye) at the Ophthalmology Department of the Army Characteristic Medical Center from June 2021 to December 2023. Among them, there were 4 males and 6 females, with an average age of (35.60±7.62) years. Uncorrected visual acuity was measured using the international standard visual acuity chart, and spherical equivalent (SE) and best corrected visual acuity (BCVA) were obtained through comprehensive optometry. Visual acuity was recorded in the form of logarithm of the minimum angle of resolution (logMAR). Objective visual quality parameters were obtained using a visual quality analysis system, and subjective visual quality was obtained through questionnaire surveys. Postoperative accommodative function and defocus curve were also examined. Various indicators before and 5 months after surgery were compared between the two eyes. Results: The BCVA in the cataract surgery eye significantly improved postoperatively (P<0.05), while no significant change was observed in the ICL implantation eye (P>0.05). Postoperative UCVA for the cataract surgery eye was 0.12±0.12 for distance, 0.18±0.18 for intermediate, and 0.28±0.20 for near vision. For the ICL implantation eye, these values were 0.10±0.11, 0.00 (0.00, 0.03), and 0.01 (0.00, 0.06), respectively. Objective scatter indices postoperatively were 2.20±1.82 for the cataract surgery eye and 0.90 (0.48, 1.90) for the ICL implantation eye. All patients became spectacle-independent postoperatively, with 6 experiencing halo phenomena that did not affect their daily life. The average patient satisfaction score was 9.5. The ICL implantation eye showed better accommodative amplitude and facility than the cataract surgery eye, with statistically significant differences (both P<0.05). The defocus curve indicated good binocular visual acuity, and no severe intraoperative or postoperative complications were reported. Conclusions: For patients with high myopia and monocular cataract, the combination of cataract surgery and ICL implantation in the contralateral eye effectively enhances postoperative visual acuity and quality, preserves natural accommodation, establishes binocular vision balance, and facilitates spectacle independence. The procedure is safe, reliable, and improves the quality of life and work.

Comparison of Q-Switched Nd:YAG LASER with 10% Azelaic Acid versus Fractional CO2 LASER with 10% Azelaic Acid in the treatment of Post Inflammatory Hyperpigmentation secondary to Acne

Background:Post inflammatory hyperpigmentation (PIH) secondary to acne is a common undesirable sequela following acne that leads to psychological distress and a sense of incomplete treatment among the patients with acne. Few studies have been done in regard to address this condition, and no definite treatment or clear ranking of treatment modalities is available as of yet.Aims:The aim of our study was to assess and compare the efficacy and safety of 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QSNY) laser with 10% azelaic acid versus Fractional carbon dioxide (FCO2) laser with 10% azelaic acid in the treatment of post acne pigmentation.Materials and Methods:Seventy patients with PIH secondary to acne were recruited in this study. The patients were randomized into two groups, Group A and Group B, of thirty-five patients each. Patients in group A underwent QSNY laser, while Group B received FCO2 laser. 10% azelaic acid cream was administered to both groups. Both groups received a total of 5 treatment sessions, with 3 weeks interval between each setting. The efficacy and safety of both modalities were assessed using the quartile grading score(QGS), post acne hyperpigmentationindex(PAHPI), patient satisfaction score, and documentation of adverse effects.Results:At the end of five sessions, significant improvement in QGS, PAHPI and patient satisfaction (P &lt; 0.001, respectively) was seen in both groups. The mean PAHPI significantly reduced after the third setting and was followed by drastic reduction in the following settings. However, significantly superior results were noted in Group A with respect to all assessments. Side effects noted were mild and transient, except two patients of Group B who developed further pigmentation over the treatment areas.Conclusion:This study shows that both QSNY laser and FCO2 laser can be used to treat post-acne pigmentation; however, QSNY laser should be preferred with respect to efficacy and safety, especially in the Indian population, owing to the higher risk of pigmentation following FCO2 laser.

Validity and reliability of a proposed anterior implant esthetic index (AIEI)

Statement of problemPatient satisfaction and esthetic acceptance are important factors in predicting the success of implant therapy in the anterior maxilla. A standardized esthetic index to evaluate implant esthetic outcomes is still lacking. PurposeThe purposes of this study were to describe the newly developed images that correlate to the pink esthetic score and white esthetic score (PES/WES) for improved standardized documentation and to evaluate the validity and reliability of the proposed anterior implant esthetic index (AIEI) with patient satisfaction scores. Material and methodsA photograph deemed ideal (perfect score of 2) using the PES/WES criteria was acquired and digitally altered to represent scores of 1 (minor discrepancy) and 0 (major discrepancy) according to the PES/WES guidelines. A pilot study enrolled prosthodontists and periodontists to review and verify the representations. A 29-question survey was developed and distributed to 33 participants on a tablet computer to evaluate the photographs. The participants were asked about their satisfaction level with the photographs on a visual analog scale from 0 to 100. Data were extracted, and ANOVA was used to compare mean satisfaction scores. Post hoc Tukey tests were used to analyze the differences within each variable (α=.05). ResultsStandardized sets of 14 altered PES and 14 altered WES photographs were generated. The interrater reliability (n=5) of the pilot study showed moderate agreement with κ=0.453 (95% CI: 0.431–0.476) for all and individual scores. Based on the patient survey, 5 of the 14 factors of the PES/WES showed no significant difference and were eliminated when constructing the index. Using scores and percentages, the anterior implant esthetic index was developed for scores of 0, 1, and 2 for each of the remaining 9 criteria. The maximum score for the index was 20 points. ConclusionsPhotographic representation of each criterion within the PES/WES standardized the patient’s ability to evaluate anterior implant esthetics. An anterior implant esthetic index was developed, and a moderate interrater reliability agreement and good validation with patient satisfaction scores were obtained.

Evidence-based Nursing and Improving Patient Satisfaction: A Systematic Evaluation

Objective: This study aims to explore the effect of evidence-based nursing (EBN) on improving patient satisfaction by systematically evaluating the impact of EBN implementation through the analysis of 40 hospital-related literature articles. Methods: A review of 40 studies published from January 2022 to December 2023 related to EBN and patient satisfaction was conducted. The selection was based on specific inclusion and exclusion criteria, focusing on studies that involved EBN interventions. Data were extracted and statistically analyzed using patient satisfaction scores and nursing quality assessments to compare satisfaction before and after EBN implementation. Results: Literature analysis showed that patient satisfaction significantly improved after the implementation of EBN, with average satisfaction scores increasing from 82.5% before intervention to 91.3% after intervention (P &lt; 0.05). The application of EBN enhanced patients’ care experience, reduced nursing errors, and significantly improved the efficiency and professional competence of healthcare staff. Conclusion: This study confirms that EBN has a significant effect on improving patient satisfaction, particularly in personalized care and evidence-based decision-making. Future efforts should promote EBN and standardize nursing processes to continuously improve care quality and patient satisfaction.

An Algorithmic Approach to use Extended Spreader Grafts in Deviated Noses.

Restoration of a straight and adequately wide nasal dorsum is challenging in patients with deviated noses. Supporting a reformed septum with an extended spreader graft (ESG) is important for maintaining position. The study aimed to describe different types of ESG and propose a comprehensive algorithm for using specific types of ESGs in rhinoplasty according to the particular type of deviated nose. It was also intended to retrospectively evaluate the long-term cosmetic results and satisfaction levels of patients who underwent rhinoplasty using different forms of ESG. We reviewed the data of seventy-six patients who underwent rhinoplasty for deviated noses from 2019 to 2023. We noted patient demographics and types of nasal deviations. We described the types of ESGs and reviewed surgical details of their utilization, complications, and scores for patient satisfaction and surgeon assessments. The most common deviations were C or reverse C in 38% of patients. Twenty-one patients had deviations with saddle deformity. ESGs were classified into four types, of which Type-C was used in 57% of cases, followed by Type-D in 21%, Type-A in 15%, and Type-B in 7% of patients. Type-A ESG was used for type-1 deviations, Type-B ESG for type-1 deviations with saddle deformity, Type-C ESG for type-2, 3 and 4 deviations, and Type-D ESG for type-2, 3 and 4 deviations with saddle deformity. Bilateral ESGs were placed with asymmetric splinting in 38% of cases. We concluded that strengthening the reconstructed septum using particular form of ESGs improves the aesthetic appearance of nose and produces consistent long-term results. The proposed guidelines will improve surgical decisions for the management of deviated noses. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report

Osteochondral defects (OCD) are a focal pathology affecting the sub-chondral bone and overlying cartilage. The presence of Osteochondral defects (OCD) within the foot and ankle are well established. Despite this, they are often regarded as an insidious finding, prone to misdiagnosis which can result in significant debilitation to the affected individual. The mechanisms underlying the formation of these lesions remain disputed. Moreover, the incidence of isolated Osteochondral defects affecting the first Metatarsophalangeal joint in the absence of any additional pathology is unknown.There are a range of surgical treatment modalities described to treat Osteochondral defects. Strategies typically involve cartilage regeneration or replacement of the articular surface: however there are no consensus guidelines regarding the optimum surgical management when applied to the first Metatarsophalangeal joint. The following concepts review aims to explore the literature pertaining to the surgical management of Osteochondral defects including an innovative approach case study employing subchondral drilling technique.Osteochondral defects are managed with a variety of surgical procedures. Surgical outcomes are often derived from literature relating to the knee and hindfoot with little or no study on the forefoot. The included case study demonstrates positive patient satisfaction (PSQ-10) score, improved foot function (MOXFQ) and pain reduction with a novel antegraded Osteochondral drilling technique when applied to the first metatarsal. Further study into the application of contemporary cartilage regeneration and replacement strategies in this location is warranted.

The Efficacy of Topical Cosmetic Containing Alpha-Arbutin 5% and Kojic Acid 2% Compared With Triple Combination Cream for the Treatment of Melasma: A Split-Face, Evaluator-Blinded Randomized Pilot Study.

While the gold standard treatment for melasma is triple combination cream (TCC), arbutin and kojic acid demonstrate their benefits and may be used as an alternative. To investigate the efficacy of cream containing alpha-arbutin 5% and kojic acid 2% (AAK) compared with TCC for melasma treatment. A split-faced, randomized study was conducted among 30 participants with melasma, and all were randomized to receive AAK or TCC on each side of their face for 12-week along with 4-week follow-up period. The melanin index (MI), modified Melasma Area Severity Index (mMASI), and physician global assessment (PGA) scores were used to measure the effectiveness of interventions. Recurrence of melasma after treatment discontinuation was evaluated by MI and mMASI. Patient satisfactions and adverse effects were also evaluated. In the analysis, the mean difference (MD) was used for MI and mMASI, while Wilcoxon signed-rank test was for the PGA scores, adverse effects, and patient satisfaction. The MD of MI and mMASI scores were not different between groups (mMASI [p = 0.344] and MI [p = 0.268]). The PGA scores only showed improvement on the TCC-treated side (p = 0.032). Compared to the AKK group, the subjects with TCC showed higher severity of recurrence (MI [p = 0.004] and mMASI [p = 0.045]). No difference in patient satisfaction score between the groups, but erythema and stinging were higher in the TCC group. The AAK cream appeared to be effective for melasma treatment, highlighting a lower recurrent rate and fewer adverse events than standard therapy. thaiclinicaltrials.org: TCTR20230124004.

Effect of different degrees of wound eversion sutures on scar formation at donor site of anterolateral thigh flaps: A prospective randomized controlled study

To investigate the effect of different degrees of wound eversion on scar formation at the donor site of anterolateral thigh flaps by a prospective clinical randomized controlled study. According to the degree of wound eversion, the clinical trial was designed with groups of non-eversion (group A), eversion of 0.5 cm (group B), and eversion of 1.0 cm (group C). Patients who underwent anterolateral femoral flap transplantation between September 2021 and March 2023 were collected as study subjects, and a total of 36 patients were included according to the selection criteria. After resected the anterolateral thigh flaps during operation, the wound at donor site of each patient was divided into two equal incisions, and the random number table method was used to group them ( n=24) and perform corresponding treatments. Thirty of these patients completed follow-up and were included in the final study (group A n=18, group B n=23, and group C n=29). There were 26 males and 4 females with a median age of 53 years (range, 35-62 years). The body mass index was 17.88-29.18 kg/m 2 (mean, 23.09 kg/m 2). There was no significant difference in the age and body mass index between groups ( P>0.05). The incision healing and scar quality of three groups were compared, as well as the Patient and Observer Scar Assessment Scale (POSAS) score [including the observer component of the POSAS (OSAS) and the patient component of the POSAS (PSAS)], Vancouver Scar Scale (VSS) score, scar width, and patient satisfaction score [visual analogue scale (VAS) score]. In group C, 1 case had poor healing of the incision after operation, which healed after debridement and dressing change; 1 case had incision necrosis at 3 months after operation, which healed by second intention after active dressing change and suturing again. The other incisions in all groups healed by first intention. At 6 months after operation, the PSAS, OSAS, and patient satisfaction scores were the lowest in group B, followed by group A, and the highest in group C. The differences between the groups were significant ( P<0.05). There was no significant difference between the groups in the VSS scores and scar widths ( P>0.05). Moderate everted closure may reduce the formation of hypertrophic scars at the incision site of the anterior lateral thigh flap to a certain extent.

Comparative evaluation of intralesional platelet rich plasma versus tranexamic acid (50mg/ml) in the treatment of facial melasma

: Melasma is a recalcitrant hyperpigmentary condition. The pathogenesis of melasma is complex and not fully understood. Although many treatment modalities have been tried for melasma but no modality is considered as gold standard.: This study aimed to compare efficacy of intralesional platelet rich plasma with tranexamic acid (50mg/ml) in the treatment of facial melasma.: Total 64 patients were enrolled in the current study from July 2023 to March 2024. In group A, 31 patients were treated with intralesional PRP and in group B, 33 patients were treated with intralesional TXA (50mg/ml). Intralesional injections were given every 4 weekly till lesions resolve or a maximum of 6 sessions followed by monthly follow up for 3 months. Grade of clinical improvement was measured by percentage reduction in mMASI score at baseline, at every session and at follow up. Patient satisfaction score was assessed using a five-point Likert scale at the end of the study.: In the PRP group, 64.52% patients showed moderate to good response whereas in the TXA group, 72.72% patients showed good to very good response. Only 41.94% patients were satisfied in group A while 81.81% patients were satisfied with their recovery after treatment in group B.: TXA was effective in all types of melasma. PRP was significantly effective only in female patients whereas TXA was significantly effecacious in both male and female patients. We suggest monthly therapy with intralesional TXA at a higher dosage of 50 mg/ml as an efficient and time-saving treatment modality over intralesional PRP.

Enhanced recovery after surgery (ERAS) a multimodal perioperative care pathway in cesarean deliveries

Enhanced Recovery After Surgery (ERAS) is an evidence based perioperative program applied for early recovery of patients after surgery to reduce the postoperative surgical stress and hasten early physiological and functional recovery. The present study is focused on application of ERAS protocol in the branch of obstetrics following cesarean sections.The primary objective is to compare the efficacy between post-operative recommendations of ERAS protocols and traditional post-operative care in cesarean sections. A total of 300 patients were included in this study from November 2020 to October 2022 from the inpatient department of Obstetrics and Gynaecology of Pradyumna Bal Memorial hospital, KIMS, Bhubaneswar. Out of 300 patients, 150 were in ERAS group and 150 were in control (conventional) group. The median Length of stay (LOS) of ERAS and control group were 3 and 5 days respectively (p&amp;#60;0.01). The median patient satisfaction score on Likert scale was 4 and 3 for ERAS and control group respectively (p&amp;#60;0.01).The application of ERAS in post-operative period after cesarean has showed significant results in decreasing length of stay and better patient satisfaction score.

Use of transanal irrigation (TAI) in the treatment of persistent bowel disorders in patients with endometriosis: A retrospective study

PurposeEndometriosis has a strong impact on women’s quality of life (QoL). Pain is the main symptom of the disease, but bowel dysfunctions such as fecal incontinence, constipation and voiding difficulties are also reported. Patients could suffer from a Low Anterior Resection Syndrome (LARS)-like syndrome. Transanal irrigation (TAI), known to alleviate LARS-related symptoms, has been suggested to aid bowel dysfunction in endometriosis patients, potentially facilitating pelvic floor rehabilitation.MethodsWe retrospectively collected data from 60 patients with endometriosis and bowel dysfunction who had been prescribed with the Peristeen® Plus TAI system. Patient satisfaction, pain, QoL and LARS score were evaluated before (baseline) and after TAI treatment (follow-up of approximately 12 months).ResultsOf the 60 patients meeting the inclusion criteria, 12 patients did not complete the questionnaires at follow-up and 16 patients discontinued treatment. Data analysis performed on 32 patients showed a mean increase of 3.6 points in patient satisfaction after TAI treatment and a mean pain reduction of 1.8 points (both, p-value < 0.001). LARS score decreased from a mean of 21.9 at baseline to a mean of 12.7 (p-value < 0.001). Accordingly, there was a notable improvement in patients’ QoL.ConclusionTAI is a useful treatment for bowel dysfunctions in patients with endometriosis. When offered to these patients, TAI seems to represent a valuable strategy to reduce pelvic floor stress. This study confirms that TAI was associated to a significantly higher patients’ satisfaction, as well as to a reduction of pain and LARS-like symptoms.

Comparative Study of Implant Placement Techniques and Their Effect on Long-Term Success of Implant-Supported Restorations

ABSTRACT Background: The long-term success of implant-supported restorations is influenced by various implant placement techniques. Materials and Methods: This randomized controlled trial involved 120 patients requiring dental implants, divided into three equal groups based on the implant placement technique: Group A (conventional submerged), Group B (one-stage non-submerged), and Group C (guided surgery). All participants were followed for three years. The primary outcomes measured were implant stability (using implant stability quotient (ISQ) values) and marginal bone loss (using radiographic analysis). Secondary outcomes included patient satisfaction and prosthetic complications. Results: The study results demonstrated significant differences among the implant placement techniques. Group C (guided surgery) exhibited the highest mean implant stability, with an ISQ value of 75.4, outperforming Group B (one-stage non-submerged) at 73.2 and Group A (conventional submerged) at 71.5. In terms of marginal bone loss, Group A demonstrated the greatest loss at 1.5 mm, whereas Group B and Group C experienced less bone loss, measuring 1.1 mm and 0.9 mm, respectively. Patient satisfaction scores were highest in Group C, with an average of 9.2 out of 10, followed by Group B at 8.7 and Group A at 8.3. Additionally, Group A recorded the highest incidence of prosthetic complications at 15%, compared to 10% in Group B and 5% in Group C, highlighting the superior performance of guided surgery in minimizing complications and enhancing overall outcomes. Conclusion: Guided implant surgery demonstrated superior outcomes in terms of implant stability, reduced marginal bone loss, and higher patient satisfaction compared to conventional submerged and one-stage techniques.

A comparative study to evaluate the safety and efficacy of low-dose isotretinoin monotherapy versus a combination of low-dose isotretinoin and superficial chemical peels in patients with moderate-to-severe acne vulgaris

Objectives: The aim of the study was to compare the safety and efficacy of low-dose isotretinoin (LDI) monotherapy versus a combination of LDI and superficial chemical peels in treating moderate-to-severe acne in patients attending tertiary care hospital. Material and Methods: Sixty patients in the age group of 15–45 years having moderate-to-severe acne vulgaris were enrolled in the study. The patients were randomly divided into two groups of 30 patients each by random table number method. Group A – patients were put on LDI (0.25 mg/kg body weight [wt]) for 3 months. Group B – LDI (0.25 mg/kg body weight) was started, and these patients were subjected to six sessions of sequential superficial chemical peels every fortnightly for 3 months. Results: Treatment outcome was measured in terms of improvement in global acne grading (GAG) score, pigmentation, scarring, and seborrhea. The mean GAG score at week 0 in Group A was 29.2 ± 5.03, and Group B was 26.7 ± 5.11. The mean GAG score at week 12 in Group A was 15.9 ± 5.09, and in Group B was 9.23 ± 3.24, which showed statistically significant improvement (P &lt; 0.001) in both groups. Post-inflammatory hyperpigmentation and erythema also improved significantly. There was no significant improvement in scarring, yet Group B showed a better response. The patient satisfaction score was high in Group B. Seborrhea improved equally in both groups. Conclusion: LDI gives a good balance between efficacy- and dose-related side effects. Both groups showed statistically significant results in terms of acne severity (global acne grading system (GAGS) W-0 26–29–W12 15– 9). Group B showed faster improvement than Group A.

Safe Anesthesia Practices for Minimally Invasive, Image-guided Procedures: CT, MRI, and Ultrasound

Background: The demand for minimally invasive, image-guided procedures, such as CT, MRI, and ultrasound, is increasing. Understanding the role of anesthesia in enhancing patient safety, comfort, and procedural success is essential. Methods: This study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, over two years, involving 150 patients. Anesthesia techniques were categorized as general anesthesia, sedation, and local anesthesia. Patient outcomes, complications, and satisfaction scores were recorded and analyzed. Results: In this study, general anesthesia was administered to 65 patients (43.3% of cases), sedation was used for 56 patients (37.3%), and local anesthesia was applied to 29 patients (19.3%). The overall procedural success rate was high, at 141 successful completions (94%), with minor complications occurring in 7 patients (4.7%) and major complications in 2 patients (1.3%). Patient satisfaction scores indicated that 96 participants (64%) reported being very satisfied with their anesthesia experience, while 45 patients (30%) indicated they were satisfied. These findings highlight the effectiveness and safety of the selected anesthesia practices in minimally invasive, image-guided procedures, demonstrating a strong correlation between appropriate anesthesia techniques and positive patient outcomes. The data underscore the importance of tailored anesthesia protocols to enhance procedural success and patient satisfaction in this clinical setting. Conclusion: The study demonstrates that tailored anesthesia practices can achieve high success rates and patient satisfaction in minimally invasive, image-guided procedures. Despite the low incidence of complications, ongoing research is needed to refine anesthesia protocols and explore advanced, image-guided techniques to further enhance patient safety and comfort.

CTNI-01. INTERVENTION OUTCOMES OF ENHANCED RECOVERY AFTER SURGERY PROTOCOL VERSUS STANDARD CARE FOR GLIOMA PATIENTS IN SELECTED HOSPITALS IN DEMOCRATIC REPUBLIC OF THE CONGO: RANDOMIZATION AND STRATIFICATION OF PROVIDERS AND HOSPITALS

Abstract BACKGROUND Enhanced Recovery after Surgery (ERAS) protocols have shown promise in improving perioperative care and patient outcomes in various surgical specialties. Aim: This study will aim to assess the efficacy of ERAS compared to the current standard of care (SOC) for glioma patients in DRC hospitals. METHODS A pragmatic, multicenter, randomized controlled trial will be designed to evaluate the outcomes of glioma patients treated with ERAS protocols versus SOC in selected hospitals in DRC. EXPECTED RESULTS A total of 100 glioma patients will be included in this study, with 50 patients in the ERAS group and 50 in the SOC group. The primary analysis will reveal that the ERAS group will have significantly fewer post-operative complications (p &amp;lt; 0.05) and a shorter length of hospital stay (p &amp;lt; 0.05) compare to the SOC group. Patient satisfaction scores will also higher in the ERAS group. Subgroup analyses by hospital center will indicate consistent trends in favor of the ERAS protocol. Randomization of providers and stratification by hospital will aim to mitigate the influence of individual provider practices and hospital-specific factors on the study outcomes. This approach will be expected to enhance the validity of the results and ensure equitable representation across hospitals. CONCLUSIONS The unique design of randomizing providers and stratifying by hospital will be a critical component of this multicenter trial, which seeks to provide valuable insights into the potential benefits of ERAS protocols for glioma patients in DRC. The findings will guide clinical practice and healthcare policy in resource-constrained settings, ultimately improving the care and outcomes of glioma patients

Efficacy of Nebulized Dexmedetomidine and Lignocaine Inhalation versus Lignocaine Alone as Premedication for Flexible Fiber-optic Bronchoscopy under Sedation: A Randomized Comparative Study.

Airway management is an integral part of general anesthesia, allowing ventilation and oxygenation and working as a mode for delivering anesthetic gases. Awake fiber-optic-guided intubation is an essential component of airway management in difficult cases. We aim to study the benefits of nebulized dexmedetomidine with lignocaine over lignocaine alone for anesthetizing the airway for flexible fiber-optic bronchoscopy. In the study, after written informed consent, 50 patients were randomly allocated into two equal groups of 25 each. The intervention group received dexmedetomidine with lignocaine nebulization, while the control group received lignocaine nebulization alone. Baseline pulse rate, blood pressure, and, at regular intervals, cough, sedation, and pain scores were recorded along with the patient satisfaction score. Parametric data were analyzed by the Student's t-test, while nonparametric data were analyzed by the Wilcoxon Mann-Whitney U test. Out of a total of 54 patients, 4 patients did not give consent to participate in the study. The demographic profile was comparable in both groups. The pulse rate was comparable in both groups throughout the procedure; however, 10 min after the procedure, the pulse rate in the lignocaine group was (mean ± standard deviation) 114.2 ± 11.52, while in the intervention group, it was 87.32 ± 7.24 with a P = 0.027. The mean blood pressure was comparable throughout the procedure. The cough score yielded a Z-score of -5.12 and a P < 0.00001 favoring the dexmedetomidine group. Similarly, Richmond agitation-sedation score and Visual Analog Scale (VAS) also favored the intervention group, with P < 0.00054 and P < 0.00001 in RASS and VAS, respectively. Patient satisfaction score analysis found a Z-score of -5.29 and a P < 0.00001. The overall results favored dexmedetomidine with lignocaine nebulization over lignocaine alone for anesthetizing airways for flexible fiber-optic bronchoscopy.

Comprehensive redesign of a rehabilitation program at Runnymede Healthcare Centre.

The redesign of the rehabilitation program at Runnymede Healthcare Centre (RHC) was designed to enhance patient care, staff satisfaction, and rehabilitation capacity. Aligned with RHC's strategic vision to become a centre of excellence for ageing and wellness, the initiative introduced a range of initiatives such as group therapy models, specific, measurable, achievable, relevant and time-bound rehabilitation goals, and enhanced leadership practices under the healthy engagement of older adults in rehabilitation therapy philosophy. Evaluation was integral to the initiative, with patient satisfaction, staff engagement, and key performance indicators continuously measured. Patient satisfaction scores, operational efficiency metrics, and staff engagement scores improved considerably. This project exemplifies how structured change management and embedded evaluation can lead to sustained improvements in patient care, staff experience, and rehabilitation outcomes.

Application of digital guide plate in repairing mandibular defects with free fibular myocutaneous flap

Objective:Exploring the clinical application effect of a series of digital designed guide plates in the repair of mandibular defects with free fibular muscle flap. Methods:A total of 32 patients who underwent fibular muscle flap repair of mandibular defects in the Head and Neck Tumor Surgery Department of Xi'an Jiaotong University Stomatological Hospital were selected as the research subjects. They were divided into a guide plate assisted group（16 cases） and a conventional surgery group（16 cases） according to the different surgical methods. The guide plate assisted group completed the surgery with the assistance of a digital design series of guide plates, while the conventional surgery group served as the control. Record the preparation and shaping time of two groups of fibular myocutaneous flaps, evaluate the surgical effect at least 6 months after surgery, and conduct a patient satisfaction survey. Use SPSS 16.0 software package to statistically process the data. Results:The preparation and shaping time of the fibular muscle flap in the guide plate assisted group were significantly shorter than those in the conventional surgery group（P<0.05）. The excellent and good rate（87.5%） of the guide plate assisted group in evaluating the surgical effect was significantly higher than that of the conventional surgery group（75.0%）（P<0.05）. The satisfaction scores of patients in the guide plate assisted group for facial shape and bite function recovery were significantly higher than those in the conventional surgery group（P<0.05）, while there was no significant statistical difference in the satisfaction scores of pronunciation function recovery between the two groups（P>0.05）. Conclusion:The design of digital guide plates can improve the accuracy of repairing mandibular defects with fibular flaps, shorten the preparation and shaping time of fibular flaps, restore good facial appearance and bite relationship of patients, and improve satisfaction. It is worth promoting and applying in clinical practice, but the design accuracy still needs to be continuously improved.