Difference between continuous positive airway pressure via mask therapy and incentive spirometry to treat or prevent post-surgical atelectasis

To assess the effect of early use of continuous positive airway pressure [CPAP] therapy to treat or prevent acute atelectasis in post-operative cardiac patients particularly smokers and elderly patients. A pilot study suggested enrolling at least 32 participants in each group to be significant. One hundred and eight patients from King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia who met the inclusion criteria participated in this study conducted between March 2010 and March 2011. The participants were divided randomly into 3 groups, incentive spirometry [IS] therapy, and CPAP therapy every 2 [CPAP2hrs], or 4 hours [CPAP4hrs]. Inspiratory capacity [IC] was used to compare the 3 therapy regimes. Simultaneously, respiratory rate [RR], heart rate [HR] and oxygen saturation [SpO[2]] were measured for all groups. Failure was defined as requiring intubation, bi-level positive airway pressure, or added chest physiotherapy. Thirty-six patients participated in each group [98 male and 10 female, with a mean age of 62 +/- 9.3 years]. The IC increased significantly in the CPAP2hrs group when compared with the control group or the CPAP4hrs group. The SpO[2] decreased significantly in the control group and the CPAP4hrs groups when compared with the CPAP2hrs group. Also, there were no significant differences in RR and HR between all groups. Early use of CPAP via mask therapy for half an hour every 2 hours had better outcomes to reopen collapsed alveoli after cardiac surgery

Extranodal stage le Non Hodgkin's Lymphoma of paranasal sinuses: a report of 7 cases and the review of literature

Study of clinicopathological behaviour of Paranasal Sinus Lymphoma in a single institution. Retrospective study of 7 patients of Clinical Stage le Non-hodgkins Lymphoma treated between 1990-1994. Department of Medical Oncology and Radiation Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi. India. 7 patients with Clinical Stage le Non-Hosgkin's lymphoma attending Out patient department. Main outcome measures: Age, Clinical presentation, Histology. Response to treatment, Patter on relapse, Leptomentingeal spread, Disease free survival. Complete response after 3 cycles of chemotherapy was noted in 4 patients; Of the 3 patients who had residual disease following 3 cycles of chemotherapy, 2 more achieved complete response with radiation therapy. One patient had progressive disease. Two patients relapsed in central nervous system within 6 months of completion of therapy. Both had partial response to chemotherapy and they also recurred loco regionally. Four patients are alive for +26, +38, +24, +28 months. We conclude that paranasal sinus non-Hodgkin's lymphoma should be treated aggressively with combination chemotherapy and radiotherapy. Their response to initial chemotherapy should be monitored carefully; Complete response to initial 3 cycles of chemotherapy predicted better outcome. Central nervous system prophylaxis with intrathecal chemotherapy and cranial irradiation should be offered to all