ABSTRACT
@#Objective: To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment. Methods: A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL. Results: There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as “failures”. Conclusion: AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements
ABSTRACT
A retrospective longitudinal study was conducted on 166 patients of clinically evident salivary gland tumours over a period of l0years with the main aim to assess the prognosis of the various surgical techniques used in the management of salivary gland tumours. All the patients underwent detailed clinical examination and FNAC. CECT and MR scan were done whenever indicated. After meticulous assessment of the extent and establishment of the cytopathological diagnosis, these cases underwent surgical excision of the tumour. Various surgical approaches were described for the excision of the tumours of various size, type and extension, with or without nodal metastasis. Neck dissection was done in 54% cases of salivary gland malignancies. Excisional biopsy was done in all of the cases. Post-operative radiotherapy was given in 26% cases. 6% cases of malignant salivary gland tumours showed recurrence