Cauterization technique for suture erosion in transscleral fixation of intraocular lenses

Transscleral suturing is a commonly applied technique to fix intraocular Implants in the sulcus.A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result In an Increased incidence of endophthalmitis.Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation.This is a simple,quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.

A Comparative Study of Closure of Tympanic Membrane Perforation between Chemical Cauterization and Fat Plug Myringoplasty

The purpose of closure of small dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Small and cost effective procedures like Chemical Cauterization and Fat Plug Myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement. A study was carried out in 69 patients with central perforations in the Department of ENT, Gauhati Medical College & Hospital for the duration of 1 year from August 11 to July 12. Out of 69 patients, 36 underwent Chemical Cauterization and 33 Fat Plug Myringoplasty. Pre-and post-operative hearing assessments of each patient were done and statistically analyzed. The success rate was found to be 83.33% and 90.9% respectively. In both groups, there was statistically significant hearing improvement with a P value 0.01. From our study, it was found that the two procedures are simple, reliable and also lessened the morbidity of the patient. Thus we recommend the use of these two official procedures for the treatment of central perforations of tympanic membrane less than 5 mm.

Usage and method of "cauterization" in Khitans people medicine based on the contents of the valuable text of medical exchanges between Iran and China called "Tanksuq-nāmeh"

Cauterization(Perian:Dāgh/Arabic:Al-Kayy or Al-Wasm)is one of the oldest methods of treatment in most ancient cultures and medical schools;the history of these methods,with archaeological studies,is estimated to be more than a few thousand years,and this issue can determine the reason for the spread of cauterizing methods in the traditional medicine of ancient civilizations,including Iran and China.The present research,as a descriptive/historical research,tries to examine the text of the manuscript of Tanksuq-nāmeh;and identify the theoretical foundations and practical methods of cauterization in Chinese and Khitans medicine,based on one of the key texts of the Ilkhanid period.(Text translated from Chinese to Persian in the 14th century AD)The results of the present study show that cauterization has a long history among the Chinese and Khitans peoples and has been performed in different ways and for different diseases.

Attenuation of corneal neovascularization by topical low-molecular-weight heparin-taurocholate 7 without bleeding complication

AIM：To investigate the antiangiogenic effects and safety of topically administered low-molecular-weight heparintaurocholate 7（LHT7） on corneal neovascularization（CoNV）.METHODS：Twenty-four Sprague-Dawley rats were randomly distributed into four groups of six rats each.The central corneas were cauterized using a silver/potassium nitrate solution.From 2d after cauterization,12.5 mg/mL（low LHT7 group） or 25 mg/mL（high LHT7group） LHT7 was topically administered three times daily;12.5 mg/mL bevacizumab was topically administered as positive control（bevacizumab） group,with normal saline（NS） administered as negative control（NS group）.The corneas were digitally photographed to calculate the CoNV percentage from the neovascularized corneal area at 1 and 2wk.RESULTS：The 4 study groups did not have different CoNV percentages at 1wk after injury（P〉0.05）.However,the low LHT,high LHT,and bevacizumab groups had significantly lower CoNV percentages than the NS group at 2wk（all P〈0.05）.No significant differences in CoNV percentage were found among the low LHT,high LHT,and bevacizumab groups（all P〉0.05）.All groups except the NS group had lower CoNV percentages at 2wk postinjury than the levels observed at 1wk（all P〈0.05）.CONCLUSION：Topically-administered LHT7 inhibited CoNV without complication after chemical cauterization in the rat.

Analysis of Endoscopic Sphenopalatine Artery Surgery for Refractory Epistaxis

Background: This study aimed to determine the safety and efficacy of sphenopalatine artery (SPA) surgery in patients with refractory epistaxis and to identify factors associated with the indications for surgery to assist clinicians in making prompt and appropriate decisions regarding SPA surgery for refractory epistaxis. Methods: We analyzed 97 consecutive patients with nasal bleeding hospitalized in our institution between April 2009 and March 2018. Clinicopathological characteristics and clinical outcomes were analyzed from retrospective chart reviews. Results: Of the 97 patients, 28 (29 sides) required SPA surgery. There were no differences in sex, anti-coagulant drug or antiplatelet use, hemoglobin concentration, or platelet count between Group A (patients who required surgery) and Group B (patients who did not require surgery). Age (58 vs. 67 years, p = 0.038) and severity of comorbidity (0 vs. 1, p = 0.039) were significantly lower in the surgery group. Patients who were younger and had lower Charlson Comorbidity Index (CCI) scores had more requirements for surgery than those who were older and had higher CCI scores. There was no significant difference between the groups with respect to the proportion of patients receiving blood transfusions;however, the length of hospitalization was significantly longer in Group A than in Group B (8.9 vs. 8 days, p = 0.038). Success rate (non-rebleeding rate) was 89%, comparable to that reported in previous studies. Conclusions: Endoscopic SPA surgery was found safe and effective method with few complications. Younger patients with lower CCI scores were found appropriate for SPA surgery for refractory epistaxis due in part to a lower risk of anesthesia.

THE RESULT OF RE-RESECTION FOR LUNG CANCER

In the study 38 cases of primary lung cancer with postoperative recurrence and metastasis or second primacy lung cancer, re-resection was performed. The time interval between the first operation and re-resection was 2 months 9 years. The resectivility rate was 89.5%.Postoperative complication rate was 23.7% and the operative mortality rate within 1 months was 5.3%. With radical re-resection 1-, 3-, 5- year survival rate were 80%,45.8% and 35% respectively. The survival time depends more on the thoroghness of resection than on the histologic type of the tumor and the tt'ne interval. It is of the opinion that wherever recurrence and/or metastasis occur. Radical re-resect'on is the treatment of choice.

Anatomical variation of the posterior septal artery leads to refractory epistaxis

Purpose:To report a rare variant of the posterior septal artery(PSA),which supplies blood to the posterior mucosa of the contralateral nasal septum.Case report:A 31-year-old female patient underwent suture removal 14 days after septoplasty and developed left-sided epistaxis 6 h after suture removal.To safely and effectively relieve the patient from epistaxis,the cauterization of the left PSA was performed under general anesthesia.However,24 h after the first surgical hemostasis,the patient experienced epistaxis again in the right nasal cavity.We have reviewed the patient's sinus computed tomography again and found a rare variant of PSA,which is the right-sided PSA passing through a bony canal in the left-sided nasal septum.Discussion:The variant of PSA well explained the failure of the first hemostatic surgery.Therefore,we again performed a cauterization of the right-sided PSA,after which the patient recovered and no further epistaxis occurred.Conclusion:When cauterization of PSA is used to manage posterior epistaxis,it is necessary to pay attention to the possible variation in PSA.