Romerohjort8572

5%) cases, while 21 (34.5%) underwent VATS. Postoperative X-ray was satisfactory in 38 (95%) cases undergoing open thoracotomy as compared to 21 (100%) cases undergoing VATS (p=value 0.29). There was no recurrence in either of the two groups over a follow-up period of six months. Overall complication rate was 32.5% (13 cases) in cases undergoing open thoracotomy, while 33.3% (7 cases) in VATS group (p=value 0.95). There was one (2.5%) mortality in open thoracotomy group, while no death occurred in VATS group. CONCLUSION Early surgical treatment, both open as well as VATS, gives satisfactory results in management of paediatric empyema. VATS is a safe alternative to open thoractomy with good success rate and less incidence of complications.OBJECTIVE To analyse the need of prophylactic antibiotic before the insertion of totally implantable venous access devices (TIVADs) in terms of preventing central line-associated blood stream infection (CLABSI) in early postoperative period in pediatric oncology patients. STUDY DESIGN A cohort study. PLACE AND DURATION OF STUDY Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore from January 2005 to June 2016. METHODOLOGY A total of 645 consecutive children with malignancy, who were implanted with TIVAD, were included in the study. The data were collected retrospectively and divided into two groups on the basis of prophylactic antibiotic administration (Group A) received the antibiotic; and Group B did not receive the antibiotic. Both the groups were compared in terms of positive central blood cultures in the absence of any other clinical source of infection during the early postoperative period of 30 days. RESULTS The overall infection rate was 12.54% (35 out of 279) in Group B (did not receive prophylactic antibiotic) and 11.68% (41 out of 351) in Group A (received prophylactic antibiotic) without any significant difference (p = 0.741). CONCLUSION There was no advantage of the use of prophylactic antibiotic before TIVAD insertion in preventing early postoperative CLABSI.OBJECTIVE To investigate the efficacy of blended learning (BL) in emergency medical resident education related to the diagnosis and treatment of benign paroxysmal positional vertigo. STUDY DESIGN A mixed-method study. PLACE AND DURATION OF STUDY Emergency Department of Hamad General Hospital, Doha, Qatar from 1st to 31st January 2018. METHODOLOGY Participating emergency medical residents were assigned to either traditional lecturing (TL) or BL groups and they used several instruments to review medical knowledge and skills before and after instruction. The residents' opinions were sought through semi-structured interviews. RESULTS Students in both groups possessed similar knowledge and skills improvement, but reported a strong preference for TL. CONCLUSION There is a need for further evaluation of learning technology and students' learning styles to maximise medical education.The impact of erythropoiesis stimulating agents (ESAs) on clinical outcomes among breast cancer patients is debatable. Current review is aimed to ascertain the efficacy of ESAs among breast cancer patients. Randomised controlled trials (RCTs) were electronically searched. Primary outcomes were mortality, blood transfusion requirements and thromboembolic events (TEEs); whereas, secondary outcomes were safety, tumor progression, anemia treatment, hemoglobin levels and quality of life (QOL). Out of 11 RCTs including 6,849 participants, 9 RCTs reported 2,312 deaths with overall mortality of 33.7%. Mortality reported for epoetin alfa (EA), epoetin beta (EB) and darbepoetin alfa (DA) was 41.24%, 73.1% and 8.99% respectively. TEEs reported for EA, EB and DA were 5.88%, 9.28% and 2.85%, respectively. Serious adverse events were 39.04%, 36.29%, 1.53% for EA, EB and DA, respectively. Tumor progression for EA and EB was 37.53% and 95.46%, respectively. No tumor progression was reported with DA. Erythropoietin reported no mortality, TEEs, serious ADRs and tumor progression. About 9% patients required transfusions during ESA therapy. Current evidence suggests that use of ESA reduces transfusion need but increases mortality and risks of TEEs.OBJECTIVE To determine whether septoplasty is an effective factor on the voice in patients with varying degrees of nasal septum deviation. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Ankara Numune Training and Research Hospital, Ear Nose Throat Clinic, Ankara, Turkey, from November 2018 to March 2019. METHODOLOGY A total of 69 patients formed groups I, II and III. Groups I, II and III consisted of patients with mild, moderate and severe nasal deviation, respectively. All patients underwent septoplasty under general anesthesia. Subjective and objective voice analyses were performed for each patient preoperatively and at the postoperative third month. RESULTS There was no statistical difference between the mean pre- and postoperative voice handicap ındex-30 (VHI-30) scores in group I and group II. Postoperative mean VHI-30 scores were significantly lower in group III. In groups I and II, the differences between the mean pre- and postoperative fundamental frequency (F0), frequency perturbation (jitter), amplitude perturbation (shimmer) and noise-to-harmonics ratio (NHR) values were not statistically significant. While the differences between the mean preoperative and postoperative F0, jitter and NHR values in group III were not statistically significant, mean postoperative shimmer value was lower than preoperative one with significantly difference. CONCLUSION Septoplasty affects the voice positively in patients having severe septum deviation.OBJECTIVE To compare and evaluate the relapse tendency of two types of fixed lingual retainers using Little's irregularity index for a follow-up of one year. STUDY DESIGN Randomised clinical trial. PLACE AND DURATION OF STUDY Department of Orthodontics, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences and Dow Dental College in Dow University of Health Sciences, Karachi, Pakistan, from November 2017 to March 2019. METHODOLOGY A total of 54 patients were recruited and divided into two groups by random allocation. Subjects who have completed fixed appliance (MBT) orthodontic treatment and non extraction cases with moderate crowding in the lower arch were included. Subjects with caries, restoration, fracture or missing lower anterior teeth were excluded. Group 1 received fiber reinforced composite (FRC) retainers and group 2 received multistranded stainless steel (MSW) retainers. They were recalled after every three months interval for one year. Relapse tendency of retainers using Little's irregularity index was evaluated at each visit. RESULTS Comparison of relapse tendency between two retainers showed statistically significant results (p less then 0.05). The mean difference of CPD between two retainers at T0 was found to be 0.09 mm (p=0.01). At T1, it was determined to be 0.3 mm (p=0.022), and at T2 it was found to be 0.3 mm (p=0.008). At T3 and T4, it was found to be 0.5 mm (p less then 0.001) and 0.5 mm (p=0.002), respectively. All mean differences were statistically significant. CONCLUSION Fiber-reinforced retainers are more effective in preventing the mandibular incisor relapse. The results of the study also suggest that the irregularity of the dentition increases with the passage of time.OBJECTIVE To determine the regular changes of blood coagulation indices in twin pregnancy complicated with preeclampsia (PE). STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Fujian Provincial Maternity and Children Hospital from January 2014 to December 2017. METHODOLOGY A total of 180 twin pregnancies were enrolled in this study, including 40 diagnosed as PE, 50 as severe PE (SPE), and 90 as normal twin pregnancies. The changes of coagulation parameters of twin pregnant women in different gestational states and periods were retrospectively analysed. RESULTS During the middle and late pregnancies in all groups, the PT (prothrombin time) decreased, and D-Di (D-dimers) increased gradually compared to early pregnancy (p 0.05). FIB in sPE group was lower than that in other two groups in late pregnancy. TT in sPE group was higher than that in other two groups. D-Di and APTT in PE group and sPE group were higher than those in normal group (p less then 0.05). The TT sensitivity was 68.8% with specificity 72.4%, at cut-off value of 13.48 s (p less then 0.01). CONCLUSION The regular changes of blood coagulation indices in twin pregnancy complicated with PE had great predictive and diagnostic value of preeclampsia.OBJECTIVE To compare lipoprotein levels, and non-HDL to high-density lipoprotein (HDL) ratios of survivors and nonsurvivors of sepsis, and to determine the predictivity levels of specified parameters in mortality. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Internal Medicine, Kirikkale University, School of Medicine, Training and Research Hospital, Kirikkale, Turkey, from December 2017 to December 2018. METHODOLOGY The study subjects included 37 non-survivors and 32 survivors of sepsis with similar ages, comorbidities, and disease activities. The total lipoprotein levels, and non-HDL to HDL ratios of the participants were compared retrospectively. RESULTS HDL and non-HDL to HDL ratios were found to be different between the two groups. The cut-off levels of these values were determined as 32 and 3.4, respectively. The cut-off levels found in the study suggest that the low HDL levels and high non-HDL to HDL ratios significantly increase the mortality risk for patients (OR=1.8 and 3.45, respectively). CONCLUSION Non-HDL to HDL ratio may be used as a useful tool for predicting sepsis mortality. These values may also be included as a part of scoring systems. Further investigations are needed to clarify the role of lipoproteins in sepsis.OBJECTIVE To explore the relationship between serum sB7-H3 and cytokines (TNF-α, IL-1β and IL-6) and to evaluate the development of Mycoplasma pneumonae pneumonia (MPP) through analysis of the expression levels of above indices in serum of children with MPP. STUDY DESIGN An experimental study. PLACE AND DURATION OF STUDY Department of Clinical Laboratory, Renmin Hospital of Wuhan University, China, from January 2018 to August 2019. METHODOLOGY One hundred and eight children with MPP were divided into severe MPP group (53 cases) and mild MPP group (55 cases) according to children's condition. Fifty children who received hernia or selective operation due to redundant prepuce were included in control group. Serum sB7-H3, TNF-α, IL-1β and IL-6 were compared. this website RESULTS Serum sB7-H3, TNF-α, IL-1β, and IL-6 levels in MPP group were higher than those in control group (all p less then 0.001); above indices in severe MPP group were higher than those in mild MPP group (all p less then 0.001). Pearson's linear correlation analysis results revealed that sB7-H3 had positive correlation with TNF-α, IL-1β, and IL-6 in MPP group (r=0.986, p less then 0.001; r=0.987, p less then 0.001; and r=0.991, p less then 0.001, respectively). CONCLUSION Detection of SB7-H3, TNF-α, IL-1β and IL-6 levels may be conducive to early diagnosis of MPP and the judgement of the severity of this disease.