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Background: To assess the outcomes of intratympanic steroids in the management of idiopathic sudden sensori-neural hearing loss. Study Design: Retrospective study. Setting: tertiary care medical centre. Methods: A total of 56patients with idiopathic sudden sensorineural hearing loss were included in our study. They received 4 doses of 0.3- 0.5ml of( 40 mg/mL ) of methylprednisolone injected into the middle ear with a gap of four days in between the doses. Pre- and post-injection hearing evaluation was done to determine overall success, morbidity, and prognostic factors. Patient variables as they related to recovery were studied and included patient’s age, time to onset of therapy, severity of hearing loss, and presence of associated symptoms. Results: A total of 56 patients were included in our study of which unilateral cases were 52 and bilateral cases were 4. Subjectively 38 patients reported improvement in hearing after the therapy while objectively we found 44 ears(74%) ,41 patients had improvement. The mean PTA pre ITS (intratympanic steroid) was 58.7 dB and after ITS it was 30.3dB. Thus mean PTA improved by 28.4 dB. Conclusion: Intratympanic steroids can be offered as a first line therapy for idiopathic sudden sensorineural hearing loss as it is minimally invasive, and can be performed as an office based procedure with no systemic side effects. No major complications has been reported in our study and results have been satisfactory.
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Background: Seroma formation is a common problem after mastectomy. The incidence varies between 30% to 92%. It is often an ongoing problem after removal of the suction drain, and repeated skin puncture is necessary to remove the seroma. In addition to many ambulatory visits this also leads to an increased risk of infection, and the adjuvant treatment can be delayed for several weeks. Different procedures have been tried to avoid seroma formation. Among these are for examples: immobilisation of the arm and shoulder after mastectomy, different drain regimens, closing of the dead space of the cavity, different chemical substances as thrombin, tranexamacid and fibrin. None of these results has been successful. Seroma formation is most likely the result of the inflammatory response due to wound healing. In the seroma fluid several factors have been detected that support this assumption. These factors are: high levels of IgG, leucocytes, granulocytes, proteinases, proteinases inhibitors, different kinds of cytokines (tPA, uPA,, uPAR, PAI-1, PAI-2, IL-6 og IL-1). On the basis of this, an inhibition of the inflammatory response might result in a decrease of seroma formation, and perhaps improve quality of life after mastectomy. Steroids inhibit the inflammatory response for example by inhibition of the cytokine function. It has been shown that a high single dose of steroid infusion (30 mg/kg solu-medrol) inhibits the normal IL 6 response after colon resection. Newer studies have shown that even at a lower dose the inflammatory response is inhibited. In several studies of head and neck surgery the oedema in surgical area is reduced after a single dose of 125 mg solumedrol. It is precisely this effect of reduced fluid formation we want to obtain in our study. We have therefore chosen to use a single dose of 125 mg of solumedrol in this study. Even at the largest single dose of glucocorticoids there have not been seen any increasing in surgical complications. S Vijayalakshmi. A comprehensive study on the effect of injection methylprednisolone in post mastectomy seroma. IAIM, 2018; 5(2): 43-47. Page 44 Aim: The aim of this study was to study the effect of injection methylprednisolone in post mastectomy seroma in patients coming to Govt. Villupuram Hospital. Materials and methods: This was a prospective study consisting of 20 patients diagnosed as carcinoma breast who underwent modified radical mastectomy in our institution. With all aseptic precautions, 125 mg methylprednisolone sodium succinate intravenously as a single bolus before the start of surgery in patients undergoing modified radical mastectomy in case group. Results: Most common age group was 41-50 years of age. In 2 cases seroma aspiration was present. Conclusion: Since Seroma formation is the most common complication of Mastectomy and among the methods used to reduce its incidence, steroid administration seems to be the most cost effective and shows promising results. Its routine use in every case is recommended under good antibiotic cover and wound care.
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Background: This study is aimed to compare the effectiveness of intra-articular injections of 2 corticosteroid preparations; triamcinolone acetonide (40 mg) and methyl prednisolone acetate (40 mg) in patients with frozen shoulder. Methods: 100 patients were enrolled randomly in our study and randomly divided into two groups. Diagnosis of frozen shoulder was made using the guidelines for shoulder complaint issued by the Dutch College of General Practitioners. The assessment of pain was by using scores of; 0 (no pain); 1 (mild); 2 (moderate); 3 (severe); 4 (severe night pain that interferes with night sleep).The outcome of intervention was assessed at 8 weeks and after that at 3 months, at 6 months and at 1 year. Results: Right side was found to be more involved than the left. Male &Female ratio was 1:3. 51% patients belong to age group 55–65. We got 62.7% satisfactory result in Group A as compared to 51.8% in Group B. Conclusion: We conclude that triamcinolone acetonide is a good rescue for painful stiff shoulder particularly for resistant cases as with diabetes mellitus, and with long duration of illness.
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Objective To investigate the effects of serum isoenzyme and inflammatory factors by large doses of methyl prednisolone shocktherapy in the treatment of patients with acute hundred withered grass poisoned.Methods 46 cases of patients with acute hundred withered grass poisoned from June 2014 to October 2015 in ningbo medical center lihuili hospital were collected and randomly divided into two groups,23 cases in each group.On the base of the conventional treatment,patients in the control group were treated by blood perfusion therapy,patients in the experiment group were treated with large dose of methyl prednisolone shock therapy on the base of the control group,tested and compared the levels of serum enzyme and inflammatory factors before and after treatment,observed the clinical symptoms,clinical efficacy and adverse reactions.Results Compared with before treatment,the levels of IL-1,IL-10,TNF-αand CRP in two groups were decreased (P<0.05),levels of CK, CK-MB, TGF-β1 and HIF-1αdecreased (P<0.05);Compared with the control group,the levels of IL-1,IL-10, TNF-αand CRP in the experiment group were lower (P<0.05);CK,CK-MB,TGF-β1 and HIF-1αlevels were lower (P<0.05),after treatment from the last row of green time,the plasma PQ clearance time and length of hospital stay were shorter (P<0.05),total effective rate was higher (P<0.05).Conclusion Large doses of methyl prednisolone shock therapy in the treatment of patients with acute hundred withered grass poisone has definite clinical efficacy , can reduce the patients’serum CK,CK-MB,TGF-β1,HIF-1αand inflammatory factors levels, with higher security.
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Objective To analyze the clinical manifestations of refractory mycoplasma pneumoniae pneumonia (RMPP)which unresponded to methylprednisolone in the dosage of 2 mg·kg-1 ·d-1 for 3 day.Methods Retrospective analysis was performed on the clinical data of 120 children with RMPP.The patients were divided into effective group and ineffective group according to ini-tial effeet of 2 mg· kg-1 · d-1 methylprednisolone.The elinical manifestations,laboratory examination,radiological features and bronchofibroscopic findings of the children were compared.Results Twenty-eight patients in 120 were poor curative effect after regular 2 mg·kg-1 ·d-1 methyl prednisolone therapy,accounted for 23.3%.There were 10 patients in 28 with mixed infection,ac-counted for 35.7%;13 patients with appeared necrotizing pneumonia,accounted for 46.4%;13 patients with secretion obstruction, accounted for 46.4%;10 patients with endometrium necrosis,accounted for 35.7%.92 patients in 120 were good curative effect af-ter regular 2 mg·kg-1 ·d-1 methyl prednisolone therapy,accounted for 76.7%.There were 5 patients in 92 with mixed infection, accounted for 5.4%;10 patients with secretion obstruction,accounted for 10.9;5 patients with secretion obstruction,accounted for 5.4%.The difference was statistically significant (P <0.05).There were correlation between effect of hormone therapy and the levels of WBC,N,hs-CRP,LDH,PCT,IL-6,IL-8,LP,SF,D-dimmer.Multiple factors analysis showed that N,hs-CRP,LDH,IL-8, IL-6 were independent risk factors influence the effect of regular hormone therapy (P <0.05).The effective were improved after in-creasing hormone doses or share ivig.Antibiotic use days in effective group was obviously lower than that in ineffective group,.The difference was statistically significant (P <0.05).Duplex control antibiotics use ratio in ineffective group was significantly higher than that in effective group.The difference was statistically significant (P <0.05).Conclusion Treatment with 2 mg·kg-1 ·d-1 methvlprednisolone could improve clinical symptoms and radiological manifestations of most children with RMPP quickly.But it may be ineffective in some situations such as N,hs-CRP,LDH,IL-8 and IL-6.
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·AIM: To evaluate the outcome of intravenous methyl-prednisolone ( IVMP) in patients with traumatic optic neuropathy (TON).·METHODS: Clinical data of 16 patients with TON who were admitted to our hospital from January 2000 to June 2006 were retrospectively analyzed. 1g of IVMP in divided doses for 3 days followed by a reducing dose of oral prednisolone for 11 days were given. Timing between the onset of injury and the initiation of treatment was noted.A change in visual acuity is the primary functional outcome measure of this study. Best corrected visual acuity (BCVA) was recorded at admission, on day 1, day 2, day 3, 1 week and 1 month after treatment.·RESULTS; Sixteen patients were included in this study with a mean age of 30. Fourteen of them were male and 2 were female. Motor vehicle accident (69%), assaults(19%) and sports (12%) were the major causes of TON. All patients had relative afferent pupillary defect at presentation. Majority of the patients (56%) have significant improvement of 3s3 lines or
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OBJECTIVE: The aim of this study is to analyze the incidence and intensity of stenosis in the anastomotic area, after tracheal resection and under tension anastomosis, with the use of methyl-prednisolone as a prophylactic agent of the tracheal stenosis. The wound healing with and without the use of corticoid was analyzed as well. METHODS: The experimental study was done in 20 mongrel dogs weighing 13± 5 Kg randomly separated into two groups. In group A (n=10) corticoid was not used and in the group B (n=10) it was used methyl-prednisolone IM 10mg/Kg. Under general anesthesia with orotracheal intubation, three tracheal rings were ressected from each animal. The force for approach the trachea extremities was 300 gf. The animals were killed with a letal dosis of anesthetic and KCl after 30 days, when the trachea was ressected in order to measure the internal diameter of the anastomosis using a digital pachymeter. The histological study of the anastomotic zone was done by the HE and Masson trichromic coloration and by a digital system to the quantitative analysis of the histologic data. RESULTS: In the group A (control) it was detected a greater stenosis index than in the B (corticosteroid) one and the difference was significant (p 0,01). The same group B revealed inflammatory reaction significantly less intense than the control (p 0,01). CONCLUSION: The data allow to conclude that the use of methyl-prednisolone in dogs submmited to tracheal resection and under tension anastomosis, contributed to decrease the intensity and frequence of stenosis of the anastomosis and reduced the inflammatory reaction in the healing tissue.
OBJETIVO: Trabalho com o objetivo de analisar a freqüência e intensidade de estenose traqueal após ressecção e anastomose sob tensão; ação da metilprednisolona como agente profilático da estenose traqueal e a caracterização dos fenômenos da cicatrização com e sem o uso de corticóide. MÉTODOS: Foram utilidados 20 cães mestiços pesando 13± 5 Kg divididos aleatoriamente em dois grupos. No grupo A(n=10) não foi usado corticóide (controle). No grupo B foi usada a metilprednisolona IM na dose 10mg/Kg. Sob anestesia geral com intubação orotraqueal foram ressecados 3 anéis traqueais de todos animais, de modo que a força para aproximação das extremidades da traquéia foi uniformemente de 300gf. Após 30 dias de observação os animais foram tratados com dose letal de anestésico e KCl, quando foi ressecada a traquéia para medida dos diâmetros internos da anastomose e da traquéia normal, com auxílio de paquímetro digital. Na análise histopatológica com as colorações HE e tricrômico de Masson utilizou-se sistema digitalizado para quantificar as estruturas dos tecidos em cicatrização. RESULTADOS: Foi observado maior índice de estenose da traquéia no grupo A que não utilizou corticóide, do que no grupo B, com diferença significante (p 0,01). A reação inflamatória, formação de fibras colágenas e de fibroblastos ocorreu com densidade média mais intensa no grupo A, caracterizando uma diferença significante (p 0,01). CONCLUSÃO: Os dados permitem concluir que o uso da metilprednisolona em cães submetidos a ressecção de traquéia e anastomose sob tensão contribuiu para diminuir a intensidade e frequência da estenose na zona da anastomose e fez reduzir a reação inflamatória nos tecidos em cicatrização.