Routine Postoperative Treatment Research Articles

Topical Calcium channel blockers for effective post operative analgesia for hemorrhoidectomy patients; A Randomized Control Trial at a Tertiary Care Hospital.

Objective: To compare the mean pain scores after hemorrhoidectomy in patients given topical calcium channel blocker and patients being given routine post-operative treatment only. Study Design: Randomized Controlled Trial. Setting: Surgical Department of Holy Family Hospital. Period: 7th January 2022 to 7th July 2022. Material & Methods: Patients fulfilling the inclusion criteria were divided into two groups. Group A patients will receive topical calcium channel blockers whole group B will receive conventional analgesic medications. Patients in both groups underwent open hemorrhoidectomy under saddle block anesthesia. At the end of procedure, a lignocaine gel-soaked pack was placed in rectum which was removed after 6 hours. The post-operative treatment of test group was similar in all regards except that they were given 2% diltiazem ointment to apply to perianal region twice a day. Oral stool softeners were started after NPO duration. The patients were advised to start warm sitz bath and application of 2% lignocaine gel to perianal region 12 hourly after removal of pack. The patients in both groups were compared for the degree of pain on the second post-operative day using visual analogue scale. Results: In this study, on comparison of mean pain scores after hemorrhoidectomy in patients given topical calcium channel blocker and patients being given routine post-operative treatment only shows that pain in Group-A was 5.89+0.80 and in Group-B 3.60+0.77, p value was 0.0001. Conclusion: Topical Calcium Channel Blockers are effective in managing post hemorrhoidectomy pain.

Effect of thumb-tack needle on gastrointestinal function recovery after cesarean section under the concept of enhanced recovery after surgery

To observe the synergistic effect and safety of combined use of houpo paiqi mixture and thumb-tack needle on promoting gastrointestinal function recovery after cesarean section. Parturients receiving cesarean section were randomly divided into the control group (29 cases), the traditional Chinese medicine (TCM) group (30 cases) and needle+TCM group (30 cases). The control group received only routine postoperative treatment. Besides the treatment as the control group, parturients in the TCM group were given 50 mL houpo paiqi mixture 6 h and 10 h after cesarean section respectively. Besides the treatment as the TCM group, parturients in the needle+TCM group received thumb-tack needle treatment at bilateral Zusanli(ST36), Tianshu(ST25), Shangjuxu(ST37) and Sanyinjiao(SP6), Zhongwan(CV12), Qihai(CV6), with auricular pressure at bilateral otopoints Zigong(Uterus), Wei(Stomach) and Dachang(Large intestine), within 1 h after the parturients returned to the ward after the operation. Each acupoint was pressed for 10 s and performed acupressure every 4 h (except sleeping hours), continuously for 3 d. The time of bowel sound recovery, the time to the first postoperative exhaust and defecation, the time of postoperative semi-fluid diet recovery, incidence of postoperative nausea and vomiting (PONV) and abdominal distention, and abdominal pain VAS score were recorded and analyzed. The safety of the treatments was also evaluated. Compared with the control group, the time of bowel sounds recovery, the time to the first postoperative exhaust and the time of postoperative semi-fluid diet recovery were significantly shortened in the TCM and needle+TCM groups (P<0.01); the time to the first postoperative defecation were significantly shortened (P<0.01), incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group (P<0.05, P<0.01); incidence of abdominal distention were significantly decreased in TCM group (P<0.05). Compared with the TCM group, the time of bowel sounds recovery, the time to the first postoperative exhaust and defecation, and the time of postoperative semi-fluid diet recovery were significantly shortened (P<0.01), and incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group (P<0.05). VAS scores of the three groups decreased gradually over time (P<0.01). Compared with the control and TCM groups, VAS scores of the needle+TCM group significantly decreased at 24 h, 48 h and 72 h after operation (P<0.01). No treatment-related adverse reactions were observed during the whole trial. On the base of the treatment with houpo paiqi mixture, the addition of thumb-tack needle treatment exerted positive synergistic effect on gastrointestinal function recovery after cesarean section, with high safety, which is worthy of clinical application.

Prognostic significance of hemoglobin, albumin, lymphocyte, platelet in gastrointestinal stromal tumors: A propensity matched retrospective cohort study.

BACKGROUNDThe combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP) can reflect systemic inflammation and nutritional status simultaneously, with some evidence revealing its prognostic value for some tumors. However, the effect of HALP on recurrence-free survival (RFS) in patients with gastrointestinal stromal tumors (GISTs) has not been reported. AIMTo investigate the prognostic value of HALP in GIST patients.METHODSData from 591 untreated patients who underwent R0 resection for primary and localized GISTs at West China Hospital between December 2008 and December 2016 were included. Clinicopathological data, preoperative albumin, blood routine information, postoperative treatment, and recurrence status were recorded. To eliminate baseline inequivalence, the propensity scores matching (PSM) method was introduced. Ultimately, the relationship between RFS and preoperative HALP was investigated.RESULTSThe optimal cutoff value for HALP was determined to be 31.5 by X-tile analysis. HALP was significantly associated with tumor site, tumor size, mitosis, Ki67, National Institutes of Health (NIH) risk category, and adjuvant therapy (all P < 0.001). Before PSM, GIST patients with an increased HALP had a significantly poor RFS (P < 0.001), and low HALP was an independent risk factor for poor RFS [hazard ratio (HR): 0.506, 95% confidence interval (95%CI): 0.291-0.879, P = 0.016]. In NIH high-risk GIST patients, GIST patients with low HALP had a worse RFS than patients with high HALP (P < 0.05). After PSM, 458 GIST patients were identified; those with an increased HALP still had significantly poor RFS after PSM (P < 0.001) and low HALP was still an independent risk factor for poor RFS (HR: 0.558, 95%CI: 0.319-0.976, P = 0.041). CONCLUSIONHALP was significantly correlated with postoperative pathology and postoperative treatment. Furthermore, HALP showed a strong ability to predict RFS in GIST patients who underwent radical resection.

Cefotaxime resistance in bile samples is an independent predictor of deep infectious complications after pancreaticoduodenectomy in patients with endoprosthesis.

Bacteriobilia may increase the rate of deep infectious complications (DIC) after pancreaticoduodenectomy. To better adjust prophylactic and empirical antibacterial treatment, we aimed to characterize bacteriobilia in patients with preoperative endoprosthesis, and its association with postoperative DIC. All patients who underwent pancreaticoduodenectomy in our center between 2010 and 2019 were included. The association between microbiological findings from bile samples, and postoperative DIC was analyzed, and we compared microbiology data between 2010-2014 and 2015-2019 periods. We enrolled 578 patients (median age 67 years [59-72], 58.7% males), of whom 220 (38.1%) had preoperative biliary endoprosthesis, with 197 (89.5%) positive preoperative bile samples pathogens were Enterobacterales, enterococci, and Candida albicans. The incidence of DIC was similar in patients with or without endoprosthesis (20.4% vs 17.8%, P=.352). Bacterial isolates collected during 2015-2019 were more resistant to cefotaxime than those recovered from 2010-2014 (45.5% vs 25.5%, P=.009). The only independent risk factor for DIC in patients with endoprosthesis was cefotaxime resistance in bile (hazard ratio 3.027 [1.115-8.216], P=.03). The incidence of DIC is high after pancreaticoduodenectomy, with or without endoprosthesis, despite routine postoperative treatment. Cefotaxime resistance, the only independent predictor of DIC in patients with endoprosthesis, has increased over time. Hence, cefotaxime may no longer be an appropriate empirical treatment.

Free cutaneous fibular flap combined with antibiotic-loaded artificial bone graft for the treatment of antibrachial osteomyelitis of Cierny-Mader type IV

Objective To investigate the effect and application value of transplantation of the free cutaneous fibular flap combined with antibiotic-loaded calcium sulfate artificial bone graft for the treatment of antibrachial chronic osteomyelitis of Cierny-Mader type IV. Methods From August, 2013 to May, 2017, 12 cases of ulna or(and) radius chronic osteomyelitis of Cierny-Mader type IV were treated by transplantation of the free cutaneous fibular flap combined with antibiotic-loaded calcium sulfate artificial bone graft. There were 7 males and 5 females, with an average age of 36.3 (21-47) years. Pure ulnar osteomyelitis in 7 cases, radius osteomyelitis in 4 cases, and both ulnar and radius osteomyelitis in 1 case. The average range of osteomyelitis lesions was 6.3 (3.0-9.0) cm. The area of soft tissue defect (including bone scar) ranged from 8.0 cm×2.0 cm to 15.0 cm×5.0 cm. The area of the flap was 10.0 cm×3.5cm-17.0 cm×7.0 cm. The average length of the fibular flap was 8.8 (5.0-12.0) cm. Locking plate internal fixation was used in 9 cases, external fixator in 2 cases, and plate combined with external fixator in 1 case. Vancomycin/gentamicin, an effective component of calcium sulfate artificial bone, averaged 0.64 g/102.7 kU (0.4 g/64 kU-1.0 g/160 kU). Routine postoperative treatment. And monthly outpatient review in the first half year after operation, and outpatient review every 3 months after half a year. One year after operation, comprehensive evaluation of elbow, forearm and wrist function with Mayo Elbow Function Index, Anderson Forearm Double Fracture Evaluation System and Cooney Wrist Function Score. Results Vascular crisis occurred in 1 case after operation, prompt surgical exploration, and ultimately all flaps survived completely. The donor sites healed well in all cases. The lower extremity functions of donor sites had no change compared with that before operation. Followed-up of an average of 22.7 months, there were 2 cases who had sensory disturbance in the ulnar nerve innervation area and returned to normal 3 months after operation. The fibular flaps healed satisfactorily with an average healing time of 4.7 (3-6) months. No calcium sulphate artificial bone granules were seen on X-ray at 3 months after operation. One year after operation, bone healing, forearm appearance and wrist function recovered well, but elbow and forearm motor function recovered unsatisfactorily. Conclusion On the basis of mastering the applied anatomy and vascular anastomosis techniques of microsurgery, this method of transplantation of the free cutaneous fibular flap combined with antibiotic-loaded calcium sulfate artificial bone graft for the treatment of antibrachial chronic osteomyelitis of Cierny-Mader type IV has achieved satisfactory results. The recipient area is beautiful. The bone healing is reliable. And it has little influence on the recipient area and the donor area. It is worthy of clinical application. Key words: Fibular flap; Osteomyelitis; Forearm; Artificial bone; Transplantation; Microsurgical technique

The effect of acupoint massage combined with auricular seed-embedding on the recovery of gastrointestinal function in patients after appendicitis

Objective To study the effect of acupoint massage combined with auricular seed-embedding on the recovery of gastrointestinal function in patients after appendicitis. Methods A total of 70 patients with acute appendicitis in this hospital from April 2016 to April 2017 were selected as research objects.The patients were randomly divided into observation group and control group, 35 cases of each group.The control group received routine postoperative treatment, while the observation group received acupuncture point massage combined with ear acupuncture point seed burying intervention on the basis of routine nursing.Gastrointestinal function recovery, complication rate and clinical efficacy were recorded in the two groups. Results The recovery time of postoperative bowel sound, the time of first anal exhaust, the time of drainage tube removal and the time of hospitalization in the observation group were significantly less than those in the control group, and the differences were statistically significant(P 0.05). The overall therapeutic effect of observation group was significantly better than that of control group, and the difference was statistically significant(P<0.05). Conclusion After acute appendectomy, acupoint massage combined with ear point implantation is helpful to promote the recovery of gastrointestinal function. Key words: Acupoint massage; Auricular seed-embedding; Appendicitis; Gastrointestinal function

Effect of auricular point pressing combined with electroacupuncture on postoperative pain and inflammatory cytokines in children with hernia

To explore the clinical efficacy and action mechanism of auricular point pressing combined with electroacupuncture (EA) on postoperative pain in children with hernia. A total of 93 children with inguinal hernia were randomly divided into an auricular point group, an EA group and a combination group, 31 cases in each group. All the three groups were treated with routine postoperative treatment and nursing, and analgesic and sedative drugs were used when necessary. After awaking, the children in the auricular point group were treated with auricular point pressing at Shenmen (TF4), Jiaogan (AH6a) and Pizhixia (AT4); the seeds of cowherb were placed at the auricular points and the same nurse used index finger and thumbs to press the points for 2 min, and repeated after 30 min. The pressing time was 8-11 AM and 14-17 PM for 3 days. The children in the EA group were treated with EA at Sanyinjiao (SP 6) and Zusanli (ST 36); the needles were perpendicularly inserted with mild reinforcing-reducing method; EA instrument was connected with needles and the current intensity was under the maximal tolerance of children; the needles were retained for 20 min, three times a day for continuous 3 days. The children in the combination group were treated with auricular point pressing and EA for 3 days. The Wong-Baker facial expression evaluation method was used to observe the pain scores 1-3 h, 4-24 h, 25-48 h and 49-72 h after operation; the contents of TNF-α, IL-6 and IL-8 were compared 1 day, 2 days and 3 days after operation; the number of cases using sedative drugs and average hospitalization days were compared among the three groups. ①Among the children aged 8-15 years old, the pain scores 4-24 h and 25-48 h after operation in the combination group were lower than those in the auricular point group and the EA group (all P<0.05); among the children aged 4-7 years old, differences of the pain scores in each time after operation were not significant statistically among the three groups (all P>0.05). ②The contents of TNF-α, IL-6 and IL-8 in serum 1 day, 2 days and 3 days after operation in the combination group were lower than those in the auricular point group and the EA group (all P<0.05). ③The number of cases using analgesic and sedative drugs after operation in the combination group was fewer than that in the auricular point group and the EA group (all P<0.05). ④The average hospitalization days in the combination group were shorter than those in the auricular point group and the EA group (all P<0.05). Compared with auricular point pressing or EA alone, the combination of auricular point pressing and EA could not only effectively relieve the postoperative pain, but also reduce the expression of inflammatory cytokines in children with hernia, improving the clinical efficacy.

Preoperative Management of MGD Alleviates the Aggravation of MGD and Dry Eye Induced by Cataract Surgery: A Prospective, Randomized Clinical Trial.

Purpose To investigate the effect of preoperative treatment and postoperative enhanced anti-inflammatory treatment on alleviating meibomian gland dysfunction (MGD) and dry eye induced by cataract surgery. Design Prospective, randomized clinical trial. Methods A total of 120 cataract patients with moderate obstructive-MGD were enrolled and randomized with 60:30:30 number of patients in cohorts I, II, and III, respectively: Cohort I: routine postoperative anti-inflammatory treatment; Cohort II: preoperative treatment (warming compress, lid hygiene, and anti-inflammatory treatment) and routine postoperative anti-inflammatory treatment; Cohort III: enhanced postoperative anti-inflammatory treatment. Main Outcomes Measures All participants were examined preoperatively and postoperatively for ocular symptom score (OSS), noninvasive keratographic tear break-up time (NIKBUT), corneal fluorescein staining, Schirmer I test, lid margin, meibum quality and expressibility, and meibomian gland dropout. Results Ocular surface disorders and MGD showed aggravated status at 1 month postoperatively in Cohort I and Cohort III, and the aggravated MGD resolved by 3 months postoperatively. At 1 month postoperatively, Cohort II and Cohort III presented high NIKBUT and low OSS, lid margin, and meibum quality and expressibility (Cohort II vs Cohort I: all P<0.001, respectively; Cohort III vs Cohort I: P=0.011, P=0.024, P=0.046, P=0.045, and P=0.012, respectively). Additionally, Cohort II had better outcomes of lid margin and meibum quality and expressibility than Cohort III at 1 month postoperatively (P=0.031, P=0.026, and P<0.001, respectively). At 3 months postoperatively, Cohort II presented a significantly higher NIKBUT than Cohort I and Cohort III (P<0.001 and P=0.001, respectively). Conclusion Preoperative management of MGD is effective and optimal in alleviating obstructive-MGD and dry eye induced by cataract surgery.

PC03.01 Post-Operative Radiation Therapy or NOT: PRO

Thymic epithelial tumors are rare tumors which has been an obstacle to performing prospective randomized studies. There is definite evidence that these tumors are radio-responsive but the exact role of radiation remains unclear. An additional confounding factor is that until the proposed standardization of classification and staging by the International Thymic Malignancy Interest Group (ITMIG) there has been significant inconsistency of interpretation of both histology and staging leading to inconsistency in recommendation for post-operative radiation. Radiation fields, techniques and doses have also been very variable. Literature informing about post-operative radiation is largely reliant on single institution data and mostly retrospective work which introduces inherent bias. More recently consortiums (such as JART and ChART) were formed to try and combine data. Unfortunately most of these databases were primarily surgical based and indications for radiation and radiation techniques are not well defined. The largest data base of thymic tumors is the one established by ITMIG which has facilitated international collaboration and establishing of large retrospective and prospective databases. In this debate we will review the literature supporting the role of radiation in the post-operative setting after thymectomy. Recent studies from different institutions have produced very different results for post-operative radiotherapy and we will compare these to try to define why the results are different. The patient must have sufficient risk to justify radiation It has clearly been demonstrated that complete surgical resection is the most important prognostic factor. Improved outcomes with postoperative radiation will depend on appropriate patient selection. We will try to define the patient population that might benefit from treatment. We will also try to answer the question of routine postoperative treatment in more advanced stage disease, or only if resection is incomplete? We will explore how histology impacts on the decision to offer post-operative radiation? We will also try to define what fields would be appropriate, what techniques would be optimal and what doses should be delivered. The thymus resides in the mediastinum adjacent o heart, lungs and great vessels. Despite improved conformal techniques of radiation these organs still receive radiation and the potential damage from the radiation is not well quantified. International collaboration with standardization of definitions and complete radiation data is ultimately the only way we will achieve knowledge to advise the exact role of post operative radiation. Thymic epithelial tumors, post-operative radiation thymoma

Therapeutic efficacy of 3% NaCl hypertonic solution in postoperative corneal edema

Currently phacoemulsification (PE) is the main technique of cataract surgery, which provides for patients early clinical and functional rehabilitation. Post-operative corneal edema is a frequent and undesirable clinical situation.&#x0D; The purpose of the study was to evaluate clinical efficacy of 3% sodium chloride (Ocusaline) treatment in patients with corneal edema in the early post-operative period.&#x0D; Materials and methods. 60 patients (65 eyes) with post-operative corneal edema were included in the study. The main group consisted of 35 eyes; 30 eyes were included into the control group. Patients in the group 1 in addition to the routine post-operative treatment were treated with 3% sodium chloride hypertonic eye drops (Ocusaline); and patients in group 2 were treated according to the standard protocol. In all patients before and after surgery (in 1 day, 7 days and 1 month), subjective and objective indices of functional ophthalmic state (visual acuity, pachymetry in the central area and in the tunnel incision zone) were estimated.&#x0D; Results. The study results demonstrated that 3% sodium chloride hypertonic solution use facilitates visual acuity improvement due to the decrease of corneal thickness in the central area already at one week after surgery. The use of Ocusaline in the early post-operative period allows to decrease clinical and functional rehabilitation terms and to reduce subjective complaints of patients.

Monitoring of heart rate and inter-beat intervals with wrist plethysmography in patients with atrial fibrillation

Objective: Atrial fibrillation (AF) causes marked risk for patients, while silent fibrillation may remain unnoticed if not suspected and screened. Development of comfortable yet accurate beat-to-beat heart rate (HR) monitoring with good AF detection sensitivity would facilitate screening and improve treatment. The purpose of this study was to evaluate whether a wrist-worn photoplethysmography (PPG) device can be used to monitor beat-to-beat HR accurately during post-operative treatment in patients suffering from AF and whether wrist-PPG can be used to distinguish AF from sinus rhythm (SR).Approach: Twenty-nine patients (14 with AF, 15 with SR, mean age 71.5 years) with multiple comorbidities were monitored during routine post-operative treatment. The monitoring included standard ECG, finger PPG monitoring and a wrist-worn PPG monitor with green and infrared light sources. The HR from PPG sensors was compared against ECG-derived HR.Main results: The wrist PPG technology had very good HR and beat detection accuracy when using green light. For the SR group, the mean absolute error (MAE) for HR was 1.50 bpm, and for the inter-beat intervals (IBI), the MAE was 7.64 ms. For the AF group, the MAE for HR was 4.28 bpm and for IBI, the MAE was 14.67 ms. Accuracy for the infrared (IR) channel was worse. Finger PPG provided similar accuracy for HR and better accuracy for the IBI. AF detection sensitivity using green light was 99.0% and the specificity was 93.0%. Performance can be improved by discarding unreliable IBI periods.Significance: Results suggest that wrist PPG measurement allows accurate HR and beat-to-beat HR monitoring also in AF patients, and could be used for differentiating between SR and AF with very good sensitivity.

Contralateral sinus involvement of surgically treated unilateral allergic fungal rhinosinusitis.

Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased sinuses. We aimed to evaluate the recurrence forms of unilateral AFRS as well as to study the possible predictor factors of developing the disease in the contralateral side. Patients with exclusive unilateral AFRS from (2010 to 2015) were enrolled in multi-institutional case-control study. All patients were evaluated after endoscopic sinus surgery for recurrence. Patient's records were reviewed for demographics, medical treatment, and clinical, radiological, and surgical data. A total of 68 patients were identified. Delayed contralateral involvement after the initial surgery was found in 30.8% with mean duration of recurrence 16.9months. A significant association was found with the presence of pre-operative contralateral symptoms and signs of inflammation (OR 3.49, 95% CI 1.19-10.22, p value 0.02). Post-operative use of budesonide irrigation was associated with less contralateral involvement (OR 0.11, 95% CI 0.01-0.87, p value 0.01). Association of other variables like: comorbidities, perioperative use of systemic steroid, radiological signs, extent of surgery, additional surgery to the contralateral side, and post-operative use of systemic steroids did not show statistical significance. Involvement of the contralateral sinuses in 30% of unilateral AFRS cases is considered significant. The non-diseased sinuses should be involved in the routine endoscopic examination and post-operative treatment. Further studies are necessary to investigate the possibility of prophylactic surgical intervention of the non-diseased sinuses.

Does Physical Therapy after a TPLO Lead to Improvement of the 1-Year Post-Operative Peak Vertical Force?

&lt;p&gt;&lt;strong&gt;Clinical bottom line&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Based on the lack of sufficient clinical studies investigating the PICO question, it is not possible to conclude if physical therapy should be recommended as a routine postoperative treatment after TPLO. &lt;/p&gt;&lt;br /&gt; &lt;img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /&gt; &lt;img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /&gt;

Influence of Cognitive Behavioral Therapy on Mood and Quality of Life After Stent Implantation in Young and Middle-Aged Patients With Coronary Heart Disease.

Cognitive behavioral therapy (CBT), established only a few decades ago, is widely used by clinical psychologists. This study aimed to investigate the effects of CBT on mental status and quality of life (QOL) after percutaneous coronary intervention (PCI) in young and middle-aged patients with coronary heart disease (CHD). Seventy-five anxiety/depression patients (mean age, 52.2 ± 6.2 years, including 8 individuals < 45 years old) with CHD treated with PCI were randomly divided into a CBT group (n = 38) and control group (n = 37). The CBT group received 8 weeks of CBT in addition to the routine postoperative treatment that was also administered to control patients. The 17-item Hamilton Depression Rating Scale (HAM-D17), Hamilton anxiety scale (HAM-A), and Coronary Revascularization Outcome Questionnaire (CROQ-PTCA-POST, Chinese version) were administered before, 3 days, and 8 weeks after intervention. HAM-D17 and HAM-A scores were decreased after treatment, but were more substantially reduced in patients that underwent CBT than those in the control group (11.7 ± 4.5 versus 15.1 ± 3.9, P = 0.001 and 10.6 ± 3.4 versus 16.5 ± 4.6, P = 0.003, respectively). QOL was improved in both groups, but overall satisfaction was higher in the CBT group compared with control patients (89.3 ± 5.2 versus 77.8 ± 9.5, P < 0.05). CBT can relieve depression and anxiety after PCI in young and middle-aged patients with CHD. CBT can improve patient QOL.

The application of interventional nursing on selective bronchial artery embolization

Objective To study the interventional nursing on selective bronchial artery embolization. Methods In our hospital from 2011 January to 2013 September, 90 massive hemoptysis patients treated with selective bronchial artery embolization were randomly divided into observation and control groups, each group had 45 cases. The control group was given routine postoperative treatment, the observation group was given system nursing on the basis of the control group, the therapeutic effect and recurrence rate in two groups were compared and analyzed. Results The therapeutic effect rate of observation group(95. 56%) was significantly better than that of control patients (66. 67%, P<0. 05). The recurrence rate in observation group(2. 22%) was significantly lower than that of control group(17. 78%), P<0. 05. Conclusions Selective bronchial artery embolization in treatment of massive hemoptysis could be effective, interventional nursing can increase the effective rate and reduce the relapse rate, promote the rehabilitation of patients. Key words: Selective; Bronchial artery embolization; Interventional nursing

Effect of voice training in the voice rehabilitation of patients with vocal cord polyps after surgery

The objective of the present study was to determine the effect of voice training on the vocal rehabilitation of patients with vocal cords polyps following phonomicrosurgery. A total of 60 cases of vocal cord polyps treated by laser phonomicrosurgery were randomly divided into training and control groups with 30 cases in each group. The patients were treated with laser phonomicrosurgery, routine postoperative treatment and nursing. The training group were additionally treated with vocal training, including relaxation training, breathing training, basic pronunciation training, chewing voice training and tone sandhi pronunciation training, and attention was paid to the training steps. Subjective and objective voice evaluations of the two groups were compared three months after the surgery and the differences between groups were statistically significant (P<0.05). Voice training may significantly improve the postoperative voice quality of patients with vocal cord polyps and support rehabilitation.

Owner assessment of dogs' quality of life following treatment of neoplastic haemoperitoneum

SUSPECTED neoplastic haemoperitoneum can represent a decision-making challenge. Rapid and invasive interventions may be required to prevent deterioration; however, the definitive diagnosis and prognosis is often unknown. Diagnosis typically requires...

A Prospective, Open-label Study to Compare the Efficacy and the Safety of Topical Loteprednol Etabonate and Topical Flurbiprofen Sodium in Patients with Post-Operative Inflammation after Cataract Extraction

To study the effect of the topical Non-Steroidal Anti Inflammatory Drug (NSAID), Flurbiprofen 0.03%, as an alternative to the topical steroids for the postoperative control of inflammation in cataract surgeries. The effect of the topical NSAID, flurbiprofen sodium 0.03%, was studied and compared with that of the topical steroid - Loteprednol etabonate 0.5% suspension (as eye drops) in a prospective, open labelled study. Both the groups (20 patients each) were similar in the baseline parameters. The postoperative inflammatory response following the standard, small incision, extra capsular cataract extraction was assessed in both the groups for 28 post-operative days. The parameters which were considered for the study were conjunctival hyperaemia, ciliary congestion, corneal oedema, cells in the anterior chamber, aqueous flare and ocular pain. The severity of the postoperative inflammatory responses for both the drugs was graded on the post-operative days 1, 7, 14, 21 and 28 and it was statistically analyzed. The 2 groups did not differ statistically in the effect of the treatment for any of the variables, which included aqueous cells, flare, ciliary congestion and conjunctival congestion (p< 0.001). Both the drugs were well tolerated and no severe adverse Drug Reactions (ADRs) were caused by the topical NSAID and the topical steroid. The topical NSAID, Flurbiprofen, is as effective as the topical corticosteroid, Loteprednol and it can be used as an alternative in the routine postoperative treatment following uncomplicated cataract surgeries.

No Symptomatic Intracerebral Hemorrhage after Cardiac Surgery: A 14-Year Retrospective Study

Background: In the presence of new neurological findings occurring after cardiac surgery, the clinical question is whether to exclude symptomatic intracerebral hemorrhage (ICH), particularly in the context of routine postoperative anticoagulation treatment. Methods: This is a retrospective 14-year study including 5,275 patients who underwent cardiovascular surgery. The control cohort included all patients with acute cerebrovascular accidents hospitalized in 2 general hospitals in Jerusalem during a 2-month period in 2007 (part of a national survey). Results: After cardiac surgery, 78 patients developed ischemic strokes, mostly of large-vessel etiology. These ischemic strokes occurred more often in patients who underwent combined operations (22/647 = 3.4% vs. 45/3,489 = 1.3%; p = 0.0004). ICH was found in 6% of all acute cerebrovascular accidents in the general survey, but was absent after cardiac surgery (5 vs. 0; p = 0.02). Conclusions:Despite hypertension as a main risk factor and the administration of postoperative anticoagulation, we found that symptomatic ICH did not occur after cardiac surgery.

Effect of bromfenac ophthalmic solution on ocular inflammation following cataract surgery

This study compared the post-cataract surgery anti-inflammatory effects of topical treatment with 0.1% bromfenac, 0.1% betamethasone or both on postoperative anterior chamber inflammation and corneal swelling. Seventy-two patients with no eye disease other than cataract were enrolled in a prospective, randomized study to undergo phacoemulsification combined with intraocular lens implantation. After cataract surgery, patients were randomized to treatment with bromfenac, betamethasone or both agents. Twenty-five eyes were assigned to bromfenac, 23 to betamethasone and 24 to the combined treatment group. Inflammatory reactions in the anterior chamber were measured with laser flare photometry preoperatively and at 1 and 3 days, 1 and 2 weeks, and 1 and 2 months postoperatively. Intraocular pressure (IOP) and corneal thickness were measured at the same time-points. Best corrected visual acuity (BCVA) was measured preoperatively and at 2 days, 1 and 2 weeks, and 1 and 2 months postoperatively. Specular microscope endothelial photography of the central region of the cornea was performed preoperatively and at 3 months after surgery. There were no significant differences among the bromfenac, betamethasone and combined treatment groups in BCVA, IOP, aqueous flare or corneal thickness. Cystoid macular oedema was present in one eye treated with betamethasone. There were no significant differences in anti-inflammatory effects among the three treatments. These findings suggest that bromfenac is as effective as betamethasone in minimizing inflammatory reactions after cataract surgery.