Unilateral Versus Bilateral Research Articles

Bilateral Versus Unilateral Repair of Nasal Septal Perforation: A Two-Center Retrospective Study.

There are two main approaches for nasal septal perforation (NSP) surgery-bilateral and unilateral repair. There are advantages and disadvantages to each of these techniques. At the same time, there is a lack of comparative studies on the effectiveness of these approaches. The study aims to compare the effectiveness of unilateral and bilateral closure of NSP. A total of 99 patients with symptomatic NSP underwent surgery between 2021 and 2022 and were followed up at two large tertiary centers. The "unilateral closure" group (Group 1, N = 47) utilized an anterior ethmoidal artery (AEA) flap to close the perforations. Group 2 (N = 52) consisted of patients, who underwent bilateral closure of NSP. Complete closure of the NSP was achieved in 39 of 47 (83%) patients in Group 1 and in 48 of 52 (92.3%) patients in Group 2. There was a trend toward a higher incidence of incomplete defect closure among Group 1 patients when analyzing the subgroups of large (>2 cm) NSP (RR = 2.75 [95% CI: 0.96; 7.87], p = 0.072). There was a statistically significant decrease in SNOT-25 score after surgery in each of the study groups (p < 0.001) with no significant differences between groups (p = 0.51). The relative advantages of the thin flap are outweighed by the obtained data of higher efficacy of the bilateral technique in large NSP cases. Therefore, in cases of surgical repair of small and medium-sized NSP, the closure rates after single-layer and double-layer closure are comparable. III Laryngoscope, 2024.

Symptomatology in Unilateral Versus Bilateral Superior Canal Dehiscence Patients Undergoing Unilateral Surgery.

To compare symptomatology in patients with unilateral versusbilateral superior semicircular canal dehiscence who underwent unilateral surgical repair. Retrospective cohort study. Single surgeon series at tertiary academic medical center from 2002 to 2021. Patients were administered a standardized questionnaire regarding the presence or absence of 16 symptoms (11 auditory and 8 vestibular) pre- and postoperatively. Symptom rates were compared between patients with unilateral and bilateral dehiscence, and paired statistical testing was used to analyze symptom improvement with surgery. Our final cohort included 125 patients, 93 (74%) with unilateral superior canal dehiscence syndrome(SCDS) and 32 (26%) with bilateral SCDS. Bilateral patients had an increased burden of auditory and vestibular symptoms compared to unilateral patients before surgery (7.6 vs 6.2, P = .03) and after surgery (3.1 vs 1.9, P = .02). Both groups experienced a significant reduction of symptoms following repair (P < .01 for both). Our study has 2key findings: First, patients with bilateral dehiscence seem to be more symptomatic, reporting more auditory and vestibular symptoms both before and after surgery. Second, bilateral patients still seem to benefit from unilateral repair, demonstrating a significant reduction in the number of symptoms with surgery. Our findings may help inform the management of the sizable proportion of SCDS patients with bilateral defects.

Frequency of Unilateral Versus Bilateral Medial Tibial Stress Syndrome in Novice Footballers

Background: Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by pain along the distal two-thirds of the medial tibial border. It predominantly affects athletes engaged in weight-bearing activities, including football players. Despite its prevalence, there is limited research focusing on MTSS specifically within the context of football, particularly in relation to unilateral versus bilateral occurrences and the implications of limb dominance. Objective: The study aimed to measure the frequency of unilateral versus bilateral MTSS in footballers and to provide insights into the relationship between MTSS and limb dominance. Methods: This comparative cross-sectional study was conducted over six months from July 2021 to December 2021 across various football clubs in Lahore, Pakistan. Ethical approval was obtained from the Lahore College of Physical Therapy, and permissions were secured from club administrations. The sample comprised 140 recreational footballers aged 20-29 years, selected using non-probability convenience sampling. Participants were diagnosed using the MTSS criteria established by Marinus Winters in 2017, which included history taking and physical examination. Data collection involved a detailed questionnaire covering demographics, medical history, and sporting history. The study excluded individuals with previous surgical history, systemic diseases, or tumors. Data analysis was performed using SPSS version 25, employing descriptive and inferential statistics to examine relationships between variables. Results: The mean age of participants was 21.3 years (SD = 2.97), with a mean weight of 62.2 kg (SD = 8.1) and mean height of 5.5 feet (SD = 0.39). The sample included 97 males (69.3%) and 43 females (30.7%). MTSS was reported unilaterally in 82.2% of participants, with 67.9% (n = 95) experiencing symptoms in the right leg and 14.3% (n = 20) in the left leg. Bilateral MTSS was observed in 17.9% (n = 25) of participants. Conclusion: The majority of athletes reported unilateral MTSS, with the right leg being more commonly affected than the left. These findings suggest the need for comprehensive bilateral assessment in the diagnosis and treatment of MTSS in footballers to optimize performance and prevent recurrence.

Differences in Hearing Devices and Speech Therapy Utilization Between Children With Permanent Unilateral Versus Bilateral Hearing Loss.

In this study, we aimed to describe differences in diagnosis and both auditory and speech/language intervention utilization between children with permanent unilateral hearing loss as compared with bilateral hearing loss. A retrospective cohort study was performed of children evaluated in a multidisciplinary hearing loss clinic at a tertiary care pediatric hospital. Children aged 0 to 18 years with either permanent unilateral or bilateral hearing loss were included. One hundred fourteen children with unilateral hearing loss and 268 children with bilateral hearing loss were studied for a total of 382 children. There were no demographic differences between children with permanent unilateral versus bilateral hearing loss. Rates of newborn hearing screening and referred screening results were similar between those with unilateral and bilateral hearing loss. Despite similar rates of referred newborn hearing screening, those with bilateral hearing loss were diagnosed at a younger age (mean 3.6 years, SD 3.8 years) as compared with those with unilateral hearing loss (mean 5.0 years, SD 4.2 years). Children with unilateral hearing loss had similar severity of hearing loss in their poorer hearing ear as compared with children with bilateral hearing loss, yet they were significantly less likely to be fitted with hearing devices (53% versus 78%) or receive speech/language therapy (36% versus 54%) as compared with children with bilateral hearing loss. Multivariate analysis found that bilateral hearing loss and earlier age of hearing loss diagnosis were associated with hearing device use. Early diagnosis and intervention for childhood hearing loss have a significant impact on a child's educational success and social relationships. However, little is known about differences in diagnosis and resource utilization between children with permanent unilateral hearing loss versus bilateral hearing loss. Children with unilateral hearing loss were diagnosed at a later age and were less likely to utilize hearing devices or speech/language therapy compared with those with bilateral hearing loss, despite having similar severity of hearing loss in the poorer hearing ear. There is a strong body of evidence that children with unilateral hearing loss have improved hearing outcomes with hearing devices, which suggests there is room for improvement in identifying unilateral hearing loss and providing adequate services to optimize educational success. However, speech therapy is generally implemented in response to language delays. Therefore, children with unilateral loss may have lower rates of language delays as compared with those with bilateral hearing loss, thereby explaining differences in speech therapy utilization.

Unilateral Versus Bilateral Lesioning in Movement Disorder Other Than Parkinsons Disease

Unilateral Versus Bilateral Lesioning in Movement Disorder Other Than Parkinsons Disease

Unilateral Versus Bilateral Ultrasound Guided Tap Block Effect on Postoperative Pain Control in CS

Unilateral Versus Bilateral Ultrasound Guided Tap Block Effect on Postoperative Pain Control in CS

The Effect of Unilateral Versus Bilateral Strength Training on Isometric-Squat Peak Force and Interlimb Asymmetry in Young, Recreationally Strength-Trained Men.

To compare the effects of bilateral strength training (BLST) versus unilateral strength training (ULST) on changes in peak force (PF) and interlimb asymmetry (ILA) in the isometric squat at a 120° knee angle (ISq120). A total of 31 young, recreationally strength-trained men performed either BLST (n = 18) or ULST (n = 13), twice per week for 6weeks. The total number of repetitions, duty cycle, and effort were standardized between training groups (ie,differing only in the exercises performed). Changes in PF and ILA were assessed pretraining and posttraining. Comparable increases in PF were observed in the BLST group (mean [SD] change; 17.4% [20.5%], P = .001, standardized mean difference [SMD] = 0.45) and the ULST group (11.4% [19.1%], P = .042, SMD = 0.25). No significant changes in symmetry index (SI) scores were observed following BLST (mean [SD] change; 0 [5.7], P = .526, SMD = -0.12) or ULST (+3 [6.0], P = .702, SMD = 0.4). Individual analyses of subjects with marked ILA (ie,baseline SI score > baseline coefficient of variation) revealed a trend toward BLST being more effective at attenuating SI scores in the ISq120. Overall, both BLST and ULST are effective for increasing ISq120 PF. However, it appears that BLST may be more effective at reducing SI scores in those with marked ILA.

The Clinical Significance of pT3a Lesions as Well as Unilateral Versus Bilateral Invasion Into the Seminal Vesicle in Men With pT3b Prostate Cancer: A Proposal for a New pT3b Subclassification.

Seminal vesicle invasion (SVI) as pT3b prostate cancer generally, but not uniformly, indicates poor prognosis. To determine the clinical impact of pT3a lesions (ie, extraprostatic extension other than seminal vesicle or bladder invasion [EPE], microscopic bladder neck invasion [mBNI]), as well as unilateral (Uni) versus bilateral (Bil) SVI in pT3b disease. We assessed radical prostatectomy findings and long-term oncologic outcomes in 248 consecutive patients with pT3b disease. Focal EPE, nonfocal EPE, mBNI, Uni-SVI, and Bil-SVI were identified in 13 (5.2%), 206 (83.1%), 48 (19.4%), 109 (44.0%), and 139 (56.0%) cases, respectively. Of possible combinations, we eventually divided our cases into 3 cohorts-Group 1: Uni/Bil-SVI and EPE-/mBNI- (n = 28; 11.3%); Group 2: Uni-SVI and EPE or mBNI (n = 103; 41.5%); and Group 3: Bil-SVI and EPE or mBNI (n = 70; 28.2%) or Uni/Bil-SVI and EPE+/mBNI+ (n = 47; 19.0%). Group 3 patients showed significant adverse histopathologic findings, compared with Group 1 or Group 2 patients. Kaplan-Meier analysis revealed that the prognosis was worse in the following order: Group 1, Group 2, and Group 3; and the differences in progression-free survival between any 2 groups were statistically significant. These significant differences were also seen in subgroups, such as those without or with adjuvant therapy before recurrence and those without lymph node metastasis. Additionally, Group 3 patients had a significantly higher risk of cancer-specific mortality than Group 2 patients. In multivariate analysis (Group 2 as a reference), Group 1 (hazard ratio [HR] = 0.169, P = .01) and Group 3 (HR = 1.620, P = .04) showed significance for progression. From these significant findings, we propose a novel pT3b subclassification, namely pT3b1 (Group 1), pT3b2 (Group 2), and pT3b3 (Group 3), which more accurately stratifies its prognosis.

Resection of Colorectal Liver Metastases: Prognostic Impact of Tumor Burden Score Varies with Unilateral Versus Bilateral Metastatic Spread

Resection of Colorectal Liver Metastases: Prognostic Impact of Tumor Burden Score Varies with Unilateral Versus Bilateral Metastatic Spread

Prevalence and Outcomes of Unilateral Versus Bilateral Oophorectomy in Women With Ovarian Cancer: A Population-Based Study.

BackgroundUnilateral oophorectomy has the benefits of preserving the ovarian function of fertility and hormone secretion, but the precise inclusion criteria for candidates for this procedure remain controversial. This study aimed to compare the prevalence and therapeutic efficiency of unilateral oophorectomy in women with ovarian cancer who underwent bilateral oophorectomy; moreover, it aimed to identify the appropriate candidates for unilateral oophorectomy.MethodsFemale patients diagnosed with stage I-III ovarian cancer between 2000 and 2017 were retrospectively identified from the Surveillance, Epidemiology, and End Results program database. Overall survival (OS) and disease-specific survival (DSS) after unilateral or bilateral (salpingo-) oophorectomy were estimated. Cumulative mortality rates (CMRs) for non-cancer comorbidities were also estimated.ResultsA total of 28,480 women with ovarian cancer were included in this study, of whom 11,517 died during the study period. Of the patients, 7.5% and 48.0% underwent unilateral and bilateral oophorectomy, respectively. Overall, for stage-Ia tumors, unilateral oophorectomy was associated with remarkably better OS and DSS than bilateral oophorectomy (OS: p < 0.001; DSS: p = 0.01). For stage-Ib and stage-Ic ovarian tumor, there was no significant difference between the OS and DSS of patients treated by unilateral oophorectomy and those treated by bilateral oophorectomy. For stage-II and stage-III ovarian cancer, unilateral oophorectomy was associated with remarkably worse OS and DSS than bilateral oophorectomy. Among the reproductive-age women younger than 50 years, the OS and DSS of patients with stage-I tumors receiving unilateral oophorectomy were comparable to those receiving bilateral oophorectomy, even for high-grade stage-Ic tumors (all p > 0.05). For those aged 50 years and older, OS and DSS of patients with stage-I tumor receiving unilateral oophorectomy were significantly worse than those receiving bilateral oophorectomy, even for low-grade stage-Ia ovarian tumor (OS: p < 0.001; DSS: p = 0.02).ConclusionUnilateral oophorectomy exhibited excellent oncological superiority and was equivalent to bilateral oophorectomy for stage-I ovarian tumors among women of reproductive age. For women of reproductive age, the criteria of unilateral oophorectomy can be appropriately broadened to high-grade stage-Ic diseases because of the better performance of unilateral oophorectomy in this population.

Outcomes of Unilateral Versus Bilateral Use of the Iliac Branch Endoprosthesis for Elective Endovascular Treatment of Aorto-iliac Aneurysms.

The aim of the study was to evaluate outcomes after bilateral implantation of the Gore Excluder Iliac Branch Endoprosthesis (IBE) versus those achieved after unilateral implantation. All consecutive patients electively treated in a single center for aorto-iliac aneurysm using the IBE device between January 1, 2014, and December 31, 2018, were reviewed. Early outcome measures were technical success, 30days or in-hospital mortality, and major adverse events (MAE). Late outcome measures were survival, internal iliac artery (IIA) patency, and freedom from IIA branch instability. A total of 74 patients (97% males, mean age 74 ± 7years) were included. Thirteen patients (17%) received bilateral IBE implantation for a total of 85 vessels evaluated. The technical success rate was 97% and was not significantly different between the two groups (p = .32). Two patients died within 30days, both in the unilateral group (p = 1). No significant differences were seen in the rates of 30days MAE (p = .10). At one year, the overall survival rate was 95 ± 2% vs 90 ± 3% in the unilateral and bilateral group, respectively (Log-rank = .05). There were no differences in 1-year primary and secondary patency rates between groups (Log-rank = .75 and Log-rank = .34, respectively). Freedom from IIA branch instability at one year was also not significantly different (unilateral: 94 ± 3% vs. bilateral: 82 ± 9%, Log-rank = .22).. Bilateral IBE use for elective endovascular treatment of aorto-iliac aneurysms appears safe and feasible and may achieve satisfactory short-term and mid-term outcomes. Bilateral IBE use should be employed judiciously in the context of a comprehensive risk/benefit evaluation.

Unilateral Versus Bilateral Resistance Exercise in Postoperative Rehabilitation After ACL Reconstruction With Bone-Patellar Tendon-Bone Graft: A Randomized Controlled Trial.

Background:Lower limb muscle strength symmetry has been suggested as an essential criterion for the safe return to sports after anterior cruciate ligament (ACL) reconstruction. Limited evidence is available regarding the most effective intervention to achieve symmetry after reconstruction with contralateral bone–patellar tendon–bone (BPTB) graft.Purpose:To verify whether unilateral isotonic resistance exercise is more effective than bilateral exercise for obtaining postoperative functional and muscular strength symmetry between the donor limb and reconstructed limb for patients who received BPTB graft.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:A total of 88 patients were randomly divided into a control group (n = 44) and an intervention group (n = 44). All participants performed an 8-week exercise program starting at the beginning of the fourth postoperative month and were evaluated before and after the program. The control group performed bilateral exercises, and the intervention group performed unilateral exercises for the donor limb only (the limb with the greatest disability). The primary outcome was muscle strength (peak torque and hamstrings to quadriceps [H:Q] ratio), and the secondary outcomes were range of motion (ROM; goniometry), KT-1000 arthrometer side-to-side difference in anteroposterior knee laxity, and objective (single-leg hop test) and subjective (Lysholm score) functionality.Results:Both groups improved significantly from before to after the exercise program. The improvements were significantly greater in the intervention group regarding peak torque, H:Q ratio, flexion ROM, single-leg hop test, and Lysholm score in the donor limb (P < .001 for all), and the improvements were significantly greater in the control group regarding peak torque and single-leg hop test in the reconstructed limb (P < .001 for both). Comparison between the groups showed significantly increased symmetry regarding peak torque, H:Q ratio, and single-leg hop test in the intervention group compared with the control group (P < .001), with large effect sizes (>0.80) except for the H:Q ratio.Conclusion:Although postoperative, bilateral, isotonic resistance exercise provided better strength gains to the reconstructed limb, unilateral exercise was more effective in obtaining functional and muscle strength between-limb symmetry in patients who underwent ACL reconstruction with contralateral BPTB graft.Registration:Brazilian Registry of Clinical Trials (number RBR-22rnjh).

Comparison of Unilateral Versus Bilateral Lateral Rectus Recession for Small Angle Intermittent Exotropia: Outcomes and Surgical Dose-Responses.

To compare the surgical outcomes of unilateral lateral rectus recession to bilateral lateral rectus recession for small angle intermittent exotropia. This was a retrospective cohort study of pediatric patients with an intermittent exotropia between 16 and 20 prism diopters (PD) who underwent unilateral lateral rectus recession or bilateral lateral rectus recession at a single tertiary care pediatric hospital. The primary outcome was success (exotropia < 10 PD of esotropia < 5 PD, no decrease in stereopsis > 0.6 log arcsec, and no reoperation) at 12 months postoperatively. Secondary outcomes included survival analysis of time to surgical failure, surgical dose-response, and improvement in central fusion or stereopsis. At 12 months, successful outcomes were achieved in 13 of 27 patients (46%) in the bilateral lateral rectus recession group and 19 of 28 patients (70%) in the unilateral lateral rectus recession group, which was not a statistically significant difference (P = .10). Survival analysis showed a trend toward a higher rate of failure in the bilateral lateral rectus recession group compared to the unilateral lateral rectus recession group (P = .04). The mean surgical dose-response was 1.7 PD/mm at 1 week and 1.0 PD/mm at 12 months for the bilateral lateral rectus recession group, and 2.0 PD/mm at 1 week postoperatively and 1.4 PD/mm at 12 months postoperatively for the unilateral lateral rectus recession group. There were no cases of long-term postoperative lateral incomitance in either group. Unilateral lateral rectus recession and bilateral lateral rectus recession have similar success rates for small angle intermittent exotropia after at least 12 months of follow-up. Randomized controlled trials in surgical management of intermittent exotropia should consider unilateral lateral rectus recession as a treatment arm. [J Pediatr Ophthalmol Strabismus. 2022;59(5):350-355.].

The Clinical Impact of Unilateral Versus Bilateral Invasion Into the Seminal Vesicle in Patients With Prostate Cancer Undergoing Radical Prostatectomy.

Seminal vesicle involvement by prostate cancer has generally been considered as a key prognosticator. To assess the clinical significance of unilateral (Uni) versus bilateral (Bil) seminal vesicle invasion (SVI). We compared radical prostatectomy findings and long-term oncologic outcomes in 248 patients showing Uni-SVI (n = 139) versus Bil-SVI (n = 109). Tumor grade was significantly higher in Bil-SVI cases than in Uni-SVI cases. Additionally, Bil-SVI was significantly associated with a higher incidence of lymphovascular invasion, lymph node metastasis, or positive surgical margin, and larger estimated tumor volume. When the histopathologic features at SVI foci were compared, Grade Group (GG) 3-5/4-5/5 and cribriform morphology were significantly more often seen in Bil-SVI. Outcome analysis revealed that patients with Bil-SVI had a significantly higher risk of disease progression (P < .001) than patients with Uni-SVI. Significantly worse progression-free survival in patients with Bil-SVI was also observed in all subgroups examined, including those with no immediate adjuvant therapy (IAT) (n = 139; P = .01), IAT (n = 109; P = .001), pN0 disease (n = 153; P = .002), or pN1 disease (n = 93; P = .006). In multivariate analysis, Bil-SVI (versus Uni-SVI) showed significance for progression in the entire (hazard ratio [HR] = 1.83, P = .01), IAT (HR = 2.90, P = .006), and pN0 (HR = 2.05, P = .01) cohorts. Meanwhile, tumor grade at SVI (eg, GG4, GG5), as an independent predictor, was significantly associated with patient outcomes. Bil-SVI was found to be strongly associated with worse histopathologic features on radical prostatectomy and poorer prognosis. Pathologists may thus need to report Uni-SVI versus Bil-SVI, along with other histopathologic findings, such as Gleason score, at SVI in prostatectomy specimens.

Right Unilateral Versus Bilateral Electroconvulsive Therapy in Patients With Clinical Depression

IntroductionElectroconvulsive therapy (ECT) is a functional treatment for a significant mental illness that involves a momentary application of electrical stimulation to induce generalized seizures. The use of right unilateral (RUL) and bilateral (BL) ECT has been controversial. Thus, the study aimed at comparing the effectiveness of RUL ECT and BL ECT in treating depression.MethodologyA longitudinal study was conducted between September 2016 and January 2021 at a tertiary care hospital in Sindh, Pakistan. All patients over the age of 18 with clinically diagnosed depression in the last month were included in the study. Baseline depression scores and post-treatment scores were determined using Hamilton Depression Rating Scale (HDRS). All patients were assigned to each treatment group. Group A was administered right unilateral electroconvulsive therapy, while group B was administered bilateral electroconvulsive therapy. Adverse effects were documented right after treatment, at four hours, and then one day after therapy. Depression severity was determined after each ECT session using the HDRS scale. Electroconvulsive therapy was discontinued when an HDRS score of 10 was achieved. Results The mean HDRS score at baseline in the bilateral ECT group was 24.99 ± 3.938, which lowered to 17.56 ± 2.65 by the 3rd session, 12.45 ± 3.76 by the 6th session, and to 11.86 ± 2.3 by the end of treatment (p<0.0001). Similarly, the right unilateral ECT was equally effective in improving the depressive symptoms (p<0.0001). There was no significant difference between the efficacy of bilateral and unilateral placements of electrodes in electroconvulsive therapy (p=0.116).

Combined Electric and Acoustic Stimulation (EAS) in Children: Investigating Benefit Afforded by Bilateral Versus Unilateral Acoustic Hearing.

Electric and acoustic stimulation (EAS) with preserved hearing in the implanted ear provides benefit for speech understanding, spatial hearing, and quality of life in adults. However, there is limited research on EAS outcomes in children. The aims of this study were to estimate the magnitude of EAS-related benefit on speech understanding in children with preserved acoustic hearing and to determine what role acoustic interaural time difference (ITD) sensitivity may have on said EAS benefit. Six children with acoustic hearing preservation and 20 children with normal hearing (NH) were recruited to participate. Speech recognition was assessed via an eight-loudspeaker array with speech presented from one loudspeaker at 0 degree and restaurant noise from all other loudspeakers (45-315 degrees). ITD thresholds were measured for a 250-Hz signal presented acoustically via insert earphones. Only one EAS listener demonstrated significant benefit from bilateral acoustic hearing as compared with acoustic hearing from a single ear. ITD thresholds were poor in the range of 302 to 1000+ ms and were considerably poorer than ITD thresholds for the NH group. These data suggest that children with acoustic hearing preservation may not exhibit initial EAS benefit for speech recognition in semi-diffuse noise; however, because none exhibited a decrement in performance with bilateral acoustic stimulation, EAS fittings are recommended to provide binaural acoustic access allowing for EAS adaptation to binaural cues over time. Future research should address the emergence of EAS benefit, binaural cue sensitivity, and the role of EAS experience in children and adults.

Efficacy of Hyperbaric Bupivacaine a nd Clonidine Combination Used as Unilateral Versus Bilateral Spinal Anesthesia During Unilateral Inguinal Hernia Surgery

The lump in the groin of patients with Inguinal hernias goes away with the application of slight pressure or by making the patient lie down. This study compared the efficacy of hyperbaric bupivacaine with clonidine in unilateral versus bilateral spinal anaesthesia during unilateral inguinal hernia surgery. The study was conducted in Chitwan Medical College from September 2019 to February 2020 including 50 patients aged 25-60, ASA grade of I -II and undertaking elective hernioplasty. Patients were randomized into the following groups: Group A received unilateral Inj. Bupivacaine 0.5% heavy 12.5mg + Inj. Clonidine 15mg in the sub-arachnoid block; Group B received bilateral Inj. Bupivacaine 0.5% heavy 12.5mg + Inj. Clonidine 15mg in the subarachnoid block. Variation in the motor block, duration of sensory, hemodynamic parameters, onset, and peak level were noted. The mean ‘onset of sensory block’ in group A and group B was 1.52 minutes and 1.27 minutes, respectively. The ‘duration of sensory block’ was 237.1 minutes in group A and 218.4 minutes in group B. The ‘time to achieve peak’ was 8.32 minutes in group A and 8.12 minutes in group B. The ‘time to onset of motor block’ was 1.45 minutes and 1.72 minutes in group A and group B, respectively. However, ‘the duration of motor block’ was significantly higher in group A (210.5 minutes) than group B (198.1 minutes) (P&lt; 0.05). A significantly higher mean arterial pressure was found in group A than group B (P&lt; 0.05), which was recorded 1, 5, 15, 60, 90, and 120 minutes pre-operatively. Unilateral spinal anaesthesia achieves stable hemodynamics, adequate duration of the block for surgery, and rapid recovery compared to bilateral spinal anaesthesia.

Effects of Unilateral Versus Bilateral Plyometric Training on Endurance Running Performance

The purpose of the study was to investigate the effects of an 11-week unilateral versus bilateral plyometric training intervention on maximal isometric voluntary (MVC) knee extensor torque, countermovement jump height (CMJ), running economy (RE) and 3-km time trial (TT) performance. Twenty-seven recreationally trained endurance runners (12 females and 15 males) were randomly assigned to one of three groups: unilateral plyometric training (UPT; n = 9), bilateral plyometric training (BPT; n = 9) and control (CON; n = 9). RE, VO2max, 3-km treadmill TT, isometric MVC (bilateral and unilateral) and CMJ (bilateral and unilateral) were measured prior to and after 11 weeks of training (UPT and BPT; volume equated, 20-40 minutes, 2-3 days/week). Separate two-way repeated measures ANOVAs were used to assess within and between group differences in RE, VO2max, 3-km TT, maximal isometric knee extensor torque and CMJ. Following 11 weeks of plyometric training there were significant improvements in RE (UPT 5.6%; BPT 4.9%, p &lt; 0.01) and 3-km TT performance (UPT 2.4%; BPT 2.5%, p &lt; 0.01) in addition to CMJ (UPT 12.5%; BPT 14.5%, p &lt; 0.01) and maximal isometric knee extensor torque in the unilateral group (14.0%, p &lt; 0.01). No significant differences in VO2max or anthropometric measures were detected (p &gt; 0.05). No statistically significant differences between training interventions (p &gt; 0.05) were detected in any measure. These data demonstrate that UPT and BPT result in similar improvements in RE and 3-km TT run performance in recreational distance runners.

Effects of Unilateral Versus Bilateral Plyometric Training on Endurance Running Performance

The purpose of the study was to investigate the effects of an 11-week unilateral versus bilateral plyometric training intervention on maximal isometric voluntary (MVC) knee extensor torque, countermovement jump height (CMJ), running economy (RE) and 3-km time trial (TT) performance. Twenty-seven recreationally trained endurance runners (12 females and 15 males) were randomly assigned to one of three groups: unilateral plyometric training (UPT; n = 9), bilateral plyometric training (BPT; n = 9) and control (CON; n = 9). RE, VO2max, 3-km treadmill TT, isometric MVC (bilateral and unilateral) and CMJ (bilateral and unilateral) were measured prior to and after 11 weeks of training (UPT and BPT; volume equated, 20-40 minutes, 2-3 days/week). Separate two-way repeated measures ANOVAs were used to assess within and between group differences in RE, VO2max, 3-km TT, maximal isometric knee extensor torque and CMJ. Following 11 weeks of plyometric training there were significant improvements in RE (UPT 5.6%; BPT 4.9%, p &lt; 0.01) and 3-km TT performance (UPT 2.4%; BPT 2.5%, p &lt; 0.01) in addition to CMJ (UPT 12.5%; BPT 14.5%, p &lt; 0.01) and maximal isometric knee extensor torque in the unilateral group (14.0%, p &lt; 0.01). No significant differences in VO2max or anthropometric measures were detected (p &gt; 0.05). No statistically significant differences between training interventions (p &gt; 0.05) were detected in any measure. These data demonstrate that UPT and BPT result in similar improvements in RE and 3-km TT run performance in recreational distance runners.

Unilateral Versus Bilateral Biliary Drainage for Post-Transplant Anastomotic Stricture

Living donor liver transplantation is the most common type of liver transplantation in Asia. Post-transplant biliary stricture is frequent in living donor liver transplantation, and endoscopic management is considered to be the treatment of choice. However, endoscopic management is still challenging in patients who undergo right lobe living donor liver transplantation because of the anatomical alteration. In this article, we reviewed the recently updated results for proper endoscopic biliary drainage in post-living donor liver transplantation anatomical biliary stricture and compared unilateral and bilateral drainage.