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Background: This study aims to investigate whether a novel herbal extract blend, KaraShieldTM could be used to help build a healthy immune system that could reduce the number of incidences or severity of common upper respiratory tract infections (URTIs). Methods: A randomized, parallel, double-blind, placebo-controlled clinical study of 60 days was done on 120 healthy subjects allocated to a treatment arm (500 mg/day, KaraShieldTM) or placebo arm (500 mg/day). Results: A 500 mg daily dosage of KaraShieldTM significantly improved the subjects' immune health as measured by parameters such as the frequency and severity of upper respiratory tract conditions, the serum IgG level, mean ISQ raw score, WURSS scale score, CRP level in the serum and WHOQOL-BREF score at the end of the study period of sixty days from the baseline compared to that of the placebo. The investigated product was found to be safe and well tolerated by the subjects. Conclusions: KaraShieldTM may represent a promising safe and effective formulation for building a healthy immune system that could then counteract URTIs.
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Background@#No recent meta-analysis has holistically analyzed and summarized the efficacy and safety of omarigliptin in type 2 diabetes mellitus (T2DM). We conducted a meta-analysis to address this knowledge gap. @*Methods@#Electronic databases were searched to identify randomized controlled trials (RCTs) that included patients with T2DM who received omarigliptin in the intervention arm. The control arm consisted of either a placebo (passive control group [PCG]) or an active comparator (active control group [ACG]). The primary outcome assessed was changes in hemoglobin A1c (HbA1c), while secondary outcomes included variations in glucose levels, achievement of glycemic targets, adverse events (AEs), and hypoglycemic events. @*Results@#From 332 initially screened articles, data from 16 RCTs involving 8,804 subjects were analyzed. Omarigliptin demonstrated superiority over placebo in reducing HbA1c levels (mean difference, –0.58%; 95% confidence interval, –0.75 to –0.40; P<0.00001; I2=91%). Additionally, omarigliptin outperformed placebo in lowering fasting plasma glucose, 2-hour postprandial glucose, and in the percentage of participants achieving HbA1c levels below 7.0% and 6.5%. The glycemic efficacy of omarigliptin was similar to that of the ACG across all measures. Although the omarigliptin group experienced a higher incidence of hypoglycemic events compared to the PCG, the overall AEs, serious AEs, hypoglycemia, and severe hypoglycemia were comparable between the omarigliptin and control groups (PCG and ACG). @*Conclusion@#Omarigliptin has a favorable glycemic efficacy and safety profile for managing T2DM.
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ABSTRACT Mycotic aneurysms of the iliac and other large arteries are rare and are associated with increased morbidity and mortality. Treatment of mycotic aneurysms usually requires modification of the surgical technique done for cases of degenerative or atherosclerotic aneurysms. Degenerative and atherosclerotic fusiform aneurysms are usually managed with aneurysmorrhaphy using a prosthetic graft, which however is not ideal for mycotic aneurysms. Avoidance of prosthetic material at the site of mycotic aneurysm is a better option with higher chances of resolution of infection and favorable patient outcome.
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Soilless culture, a modern greenhouse cultivation technology, has rapidly developed in the past 30-40 years and offers a closed-loop system with several benefits, including the recycling of 85-90 percent of irrigation water. As the world population continues to grow at a rate of over 1%, the reduction in land availability per capita for soil-based agriculture has become a major problem, particularly in countries like India with a high population density. Soilless farming offers a viable alternative for growing high-quality vegetables, fruits, and flowers year-round on a variety of substrates, requiring limited space. This approach also aims to eradicate greenhouse soil-related problems such as soil-borne infections, poor soil fertility, and salinity. With several advantages over traditional soil crops, including shorter growth times, year-round production, and fewer diseases and pests, soilless farming comprises various methods such as hydroponics, aeroponics, and aquaponics. The technique has the potential to improve people's lives and boost economic growth by encouraging innovative businesses to engage in agriculture. Therefore, soilless farming has gained traction as an innovative solution to address land scarcity issues while producing high-quality crops sustainably.
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Postpartum ovarian vein thrombosis (OVT) is a rare condition that must be distinguished from other causes of acute abdominal pain because it presents with non-specific, predominantly lower abdominal pain. If the right ovarian vein is involved, pain would be predominantly right-sided and may be missed for acute appendicitis. OVT has been reported to occur in 0.05% to 0.18% in the postpartum period following normal vaginal deliveries, and in up to 2% following caesarean sections. Untreated, postpartum OVT can lead to serious consequences such as sepsis, pulmonary embolism, and even death. We share a case that was admitted to our hospital with symptoms of acute appendicitis that proved later to be due to postpartum ovarian thrombosis. A 28-year-old woman was admitted to our hospital on her 4th postpartum day, following a spontaneous vaginal delivery of a live born full term female baby, complaining of anorexia, nausea, and abdominal pain in her right lower quadrant accompanied by low grade fever. On examination, she appeared ill and had a significant tenderness in her right lower quadrant. An ultrasonography did not reveal any abnormality and did not visualize her appendix. Patient was referred to a consultant gynecologist and was discharged as having no obstetric nor gynaecological cause of her complaint. Patient was admitted to general surgery department where a venography CT of her abdomen confirmed a thrombus in the right ovarian vein with a normal appendix. Blood tests were positive for anticardiolipin. Patient was treated conservatively and responded well to treatment with low molecular weight heparin and antibiotics. OVT is a rare disease, occurring mostly in the postpartum period. Rapid diagnosis is needed to prevent serious consequences and unnecessary surgical procedures, especially when mimicking an acute abdomen.
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Postpartum ovarian vein thrombosis (OVT) is a rare condition that must be distinguished from other causes of acute abdominal pain because it presents with non-specific, predominantly lower abdominal pain. If the right ovarian vein is involved, pain would be predominantly right-sided and may be missed for acute appendicitis. OVT has been reported to occur in 0.05% to 0.18% in the postpartum period following normal vaginal deliveries, and in up to 2% following caesarean sections. Untreated, postpartum OVT can lead to serious consequences such as sepsis, pulmonary embolism, and even death. We share a case that was admitted to our hospital with symptoms of acute appendicitis that proved later to be due to postpartum ovarian thrombosis. A 28-year-old woman was admitted to our hospital on her 4th postpartum day, following a spontaneous vaginal delivery of a live born full term female baby, complaining of anorexia, nausea, and abdominal pain in her right lower quadrant accompanied by low grade fever. On examination, she appeared ill and had a significant tenderness in her right lower quadrant. An ultrasonography did not reveal any abnormality and did not visualize her appendix. Patient was referred to a consultant gynecologist and was discharged as having no obstetric nor gynaecological cause of her complaint. Patient was admitted to general surgery department where a venography CT of her abdomen confirmed a thrombus in the right ovarian vein with a normal appendix. Blood tests were positive for anticardiolipin. Patient was treated conservatively and responded well to treatment with low molecular weight heparin and antibiotics. OVT is a rare disease, occurring mostly in the postpartum period. Rapid diagnosis is needed to prevent serious consequences and unnecessary surgical procedures, especially when mimicking an acute abdomen.
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Gibberellic acid is a tetracyclic di-terpenoid molecule that acts as a plant hormone by promoting the growth and development of plants. Gibberellins, one of the longest-known groups of plant hormones, control several developmental and signaling processes, such as stem lengthening, germination, dormancy, flowering and floral development, as well as the senescence of leaves and fruits. Gibberellins can alter physiological and developmental processes, including plant vegetative growth, sex expression, yield, and yield components in several crops, when applied foliar. Gibberellin, therefore has significant economic and industrial significance. Their exogenous use aids in enhancing the several commercially significant and marketable traits of flowering plants and has several benefits, like being environmentally friendly and taking less time to treat the plant. Growth regulators like GA3 have finally impacted on flowering crops' physiological processes, which in turn has affected growth and flower production. To put things in perspective, current scientific advancements will significantly affect fruit productivity and quality. In this review, we have discussed the impact of gibberellins on different aspects of crop production with special emphasis on fruit crops. To make the use of these regulators ecologically and toxicologically safe for both plants and consumers, the proper concentration for exogenous applications in fruit crops should also be examined properly.
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Historically, convulsions beginning more than 48 hours, but less than 4 weeks, after delivery, known as late postpartum eclampsia, was thought to be uncommon; however, recent evidence suggests that its incidence is increasing. In addition, the presentation of late postpartum preeclampsia-eclampsia may differ from that occurring during the pregnancy. About 40% of late eclampsia has no premonitory symptoms. This contributes to difficulty in diagnosing late postpartum preeclampsia-eclampsia in an emergency department setting. Greater awareness and knowledge of this disorder by ED physicians should improve outcomes in these potentially life-threatening cases. The authors present a case of new-onset seizures occurring 07 days postpartum. The patient presented with headache, hypertension, and generalized tonic-clonic seizures to the emergency department. Postpartum eclampsia was diagnosed and IV magnesium sulphate was administered. The patient had no further seizures and did not require long-term anticonvulsants.
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As we know that fruit plays important role in the daily human diet for healthy living and is also a commercial commodity in trade and processing industries. The primary factor that customers use to determine whether or not a fruit is acceptable is its quality like appearance, shape, size, colour and taste, etc. Success in a breeding program depends upon the overall acceptability of fruit quality because most of the developed varieties having desired traits like resistance to biotic and abiotic stresses could not be commercialized and are not in commercial cultivation owing to their poor-quality traits. Therefore, the development of cultivars with desirable quality attributes in fruit crops is challenging. Quality improvement in fruit crops is restricted by several factors such as long juvenility, tall stature, environmental stress and high heterozygosity. Quality traits in fruit crops are polygenic and governed by many genes which makesit difficult to improve particular desirable traits. Many attempts have been made to enhance the qualitative characteristics of annual crops, although perennial fruit crops neatly overlook this issue. Accordingly, the use of both combined conventional and modern breeding techniques could in overcoming these problems. Biotechnological and molecular approaches like marker-assisted selection, transgenics, genomic editing, genomics cis-genics and candidate gene offer precision and reliability to reduce the breeding cycle and are also advantageous when dealing with tedious fruit crops. The challenges with fruit breeding and the state of various breeding techniques for enhancing fruit quality in fruit trees will be the main topics of this review.
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The rate and variety of advances in energy sealing technology in the last two decades has heralded new opportunities in laparoscopic and minimally invasive surgery. Reduced operating times, lower postoperative pain scores, and shorter length of stay are offset by the additional cost of such instruments. Critical to obtaining optimal clinical effects and reducing potential complications, is a thorough understanding of the proper use of each energy modality. No single device has shown a significant superiority over the other. However best combination to have is harmonic along with ligasure or perhaps now the latest wireless sonicision with ligasure to undertake most of the surgeries. Thunderbeat has advantages like faster cutting speed and minimal instrument changes. Ferromagnetic wand is the fastest available instrument with unique features. Argon beam coagulation has certain specific uses and is best for fulguration and it is definitely advantageous to have it in OT. Sonicision offered wireless ergonomics and better manoeuvrability, cheapest VSD was the conventional bipolar.
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Introduction: According to epidemiological studies, NAFLD affects 9% to 53% of India's general population, with a higher frequency among those who are overweight or obese, those who have diabetes, or those who have prediabetes. There is emerging evidence of NAFLD occurring in lean or normal weight individuals. Studies show that between 5 and 34% of lean people have NAFLD. The highest prevalence rates, which were above 30%, were seen in India. Furthermore, Asian men who are slender, healthy, and active have insulin resistance prevalence that is three to four times higher than that of men in the rest of the world. Aim: To access the prevalence and risk factors of NAFLD among lean individuals attending Gauhati Medical College & Hospital with diagnosed Fatty Liver Disease. Materials and methods: A Hospital based Cross sectional study was done. The Gastroenterology department was used to choose the study participants using a purposive sampling method. The sample was made up of all patients with fatty liver disease who visited the gastroenterology outpatient department. The study found that the prevalence of NAFLD in lean individuals is Result: 16.9%. Females are at higher risk (P=0.0313 OR: 0.08316) of developing NAFLD in lean patients. Diabetes (P=0.0260 OR: 3.667) and Hypertension (P=0.0149 OR: 4.189) are significant risk factors. Altered bilirubin levels (P=0.0035 OR: 5.829), lipid profile (P=0.0013 OR: 7.367) and AST/ALT (P=0.0166 OR: 4.321) levels is also associated with NAFLD in lean individuals. NAFLD affects 16.9% of lean Conclusion: people with a BMI under 23. Among the lean population, women have a higher chance of getting NAFLD than men. In the study population, important risk factors for NAFLD include diabetes and hypertension. Patients with NAFLD (BMI <23) are more likely to have abnormal lipid profiles, AST/ALT values and bilirubin levels than non-NAFLD fatty liver patients with BMI <23.
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Introduction: Hypertension (HTN) is a modifiable risk factor for coronary artery disease, heart failure, cerebrovascular disease and chronic renal failure. HTN affects about 1 billion people globally; by 2025, up to 1.58 billion adults worldwide are likely to suffer from complications of HTN. This study was done to know the diet and physical activity patterns and HTN among the population of three districts of Western Rajasthan. Objectives: To study the dietary and physical activity patterns among the population of Western Rajasthan. and to compare key findings among three districts Pali, Jodhpur and Barmer so that lifestyle changes can be recommended. Methods: A case-control study was done among attendees of NCD clinics of tertiary-level centers in Pali, Barmer and Jodhpur. Hospital Controls were matched to age (± 5 years) and gender Considering the prevalence of HTN to be 20%*, the proportion of exposure in the general population as 0.2, odds ratio to be 2.2, power =80%, alpha=5% sample size is estimated to be 102 cases & 102 controls (from each district). Results: Overall being married (OR= 3.3), having diabetes Cardiac disease (OR= 2.6), excessive salt consumption (OR= 2.7), moderate physical exercise less than 30 minutes (OR=1.9), using oil other than vegetable oil(OR=1.8) , Age >?60 years (OR =1.4) were the key risk factors. It was found that high BMI (BMI>27), consumption of non-vegetable oils (12.7%) was highest in Jodhpur, lack of moderate exercise for at least 30 minutes (81%), lack of sports activity (92%) was highest in Pali, least number of days/week of fruits and vegetables consumption (~1.64 days) was seen in Barmer. Conclusions: Change in quantity of salt consumption and incorporation of moderate physical exercise for >30 minutes was most followed in control of HTN among the attendees of NCD Clinics from the multiple advise given.
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In recent years there is a rapid rise in coming out of sexual and gender minority adults to their family members and society. Unfortunately, studies on unmet health needs of transgenders with a special focus to mental health is under-researched in India. The current paper aimed to explore about the mental health of transgenders and a literature search was done using PubMed, Google Scholar, and Scopus databases for the following medical subject headings (MeSH) key terms “transgender”, “mental Health”, “social stigma”, “LGBT”, “gender dysphoria”, “genderqueer”, “intersex”, “MSM”, “hijra”, “gay”, “lesbian”, “bisexual”, and “homosexual”. Transgender individuals were found to show high rates of mental health concerns. The most common mental health problems that we have shown in this review article are depression, obsessive-compulsive disorders, generalized anxiety disorders, suicidal attempts and bipolar disorders. Transgender people are at more risk for mental health problems than their heterogenous counterparts. The intervention program to eliminate or reduce these problems needs to be planned carefully, considering all the determinants
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Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions
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Objective: To assess changes in profile of psychiatric emergencies in children and adolescents (aged <19 year) during the coronavirus disease 2019 (COVID-19) pandemic compared to pre-pandemic period. Methods: The psychiatric emergency records were analyzed for the period of April, 2019 – September, 2021 to assess the pattern and profile of mental health emergencies in children and adolescents in the period before and after the onset of the pandemic lockdown (i.e., 23 March, 2020). Results: 379 consecutive child and adolescent psychiatric emergencies were identified, of which 219 were seen after the onset of pandemic. Commonest reason for referral in the pandemic group was attempted self-harm (44.3%). The ICD-10 neurotic, stress-related and somatoform disorders constituted the commonest diagnostic category, similar to pre-pandemic period. A significantly higher proportion (44% vs 28%) of children was prescribed benzodiazepines in the pandemic period, compared to the pre-pandemic period. Conclusion: The average monthly psychiatric emergencies in children and adolescents showed no increase during the pandemic period. Self-harm was the commonest cause of psychiatric referral in emergency services mental health crisis in the younger population.
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@#Primary growth hormone (GH) resistance or growth hormone insensitivity syndrome, also called Laron syndrome, is a hereditary disease caused by mutations in the GH receptor or in the post-receptor signaling pathway. This disorder is characterized by postnatal growth failure resembling GH deficiency. Differentiating the two conditions is necessary. We present the cases of two siblings, a 16-year-old female and a 9-year-old male, born from a consanguineous union. Both had normal birth weights with subsequent severe short stature and delayed teeth eruption, with no features suggestive of any systemic illness. Serum insulin-like growth factor 1 (IGF1) and insulin-like growth factor binding protein 3 (IGFBP3) were both low. Suspecting GH deficiency, provocative testing with clonidine was done revealing peak growth hormone >40 ng/mL in both patients. In view of low IGF1 and IGFBP3 and high GH on stimulation, IGF1 generation test was done for both siblings, with values supporting the diagnosis of GH insensitivity or Laron syndrome.
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Síndrome de LaronRESUMEN
@#Complete gonadal dysgenesis with 46,XY karyotype is a clinical condition characterized by the absence of testicular tissue but typical Mullerian structures in a phenotypically female individual. The condition presents as primary amenorrhoea or delayed puberty. Eventually, malignant neoplasms may arise. We report a case of a 16-year-old patient with Swyer syndrome presenting with primary amenorrhoea and with previous diagnosis four years earlier of a malignant dysgerminoma in the right ovary.
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Disgenesia Gonadal 46 XY , Disgerminoma , Disgenesia GonadalRESUMEN
Background@#No meta-analysis has analysed efficacy and safety of fast-acting aspart insulin (FIAsp) with insulin pump in type 1 diabetes mellitus (T1DM). @*Methods@#Electronic databases were searched for randomised controlled trials (RCTs) involving T1DM patients on insulin pump receiving FIAsp in intervention arm, and placebo/active comparator insulin in control arm. Primary outcome was to evaluate changes in 1- and 2-hour post-prandial glucose (1hPPG and 2hPPG). Secondary outcomes were to evaluate alterations in percentage time with blood glucose <3.9 mmol/L (hypoglycaemia), time in range (TIR) blood glucose 3.9 to 10 mmol/L, insulin requirements and adverse events. @*Results@#Data from four RCTs involving 640 patients was analysed. FIAsp use in insulin pump was associated with significantly greater lowering of 1hPPG (mean difference [MD], –1.35 mmol/L; 95% confidence interval [CI], –1.72 to –0.98; P<0.01; I2=63%) and 2hPPG (MD, –1.19 mmol/L; 95% CI, –1.38 to –1.00; P<0.01; I2=0%) as compared to controls. TIR was comparable among groups (MD, 1.06%; 95% CI, –3.84 to 5.96; P=0.67; I2=70%). Duration of blood glucose <3.9 mmol/L was lower in FIAsp group, approaching significance (MD, –0.91%; 95% CI, –1.84 to 0.03; P=0.06; I2=0%). Total hypoglycaemic episodes (risk ratio [RR], 1.35; 95% CI, 0.55 to 3.31; P=0.51; I2=0%), severe hypoglycaemia (RR, 2.26; 95% CI, 0.77 to 6.66; P=0.14), infusion site reactions (RR, 1.35; 95% CI, 0.63 to 2.93; P=0.77; I2=0%), and treatment-emergent adverse events (RR, 1.13; 95% CI, 0.80 to 1.60; P=0.50; I2=0%) were comparable. @*Conclusion@#FIAsp use in insulin pump is associated with better post-prandial glycaemic control with no increased hypoglycaemia or glycaemic variability.
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ABSTRACT Objective: The objective of this two-arm parallel randomized controlled trial was to evaluate the treatment effects and lip profile changes in skeletal Class II patients subjected to premolars extraction treatment versus fixed functional treatment. Methods: Forty six subjects fulfilling inclusion criteria were randomly distributed into Group PE (mean age 13.03±1.78 years) and Group FF (mean age 12.80±1.67 years) (n=23 each). Group PE was managed by therapeutic extraction of maxillary first premolars and mandibular second premolars, followed by mini-implant-supported space closure; and Group FF, by fixed functional appliance therapy. Skeletal, dental, and soft-tissue changes were analyzed using pre and post-treatment lateral cephalograms. Data obtained from this open label study was subjected to blind statistical analysis. Results: Extraction treatment resulted in greater increase of nasolabial angle (NLA: 3.1 [95% CI 2.08, 4.19], p<0.001), significant improvement of upper lip (UL-E line: -2.91 [95% CI -3.54, -2.28], p<0.001, UL-S line: -2.50 [95% CI -2.76, -2.24], p<0.001, UL-SnPog': -2.32 [95% CI -2.90, -1.74], p<0.01) and lower lip position (LL-E line: -0.68 [95% CI -1.36, 0.00], p<0.01, LL-S line: -0.55 [95% CI -1.11, 0.02], p<0.01, and LL-SnPog': -0.64 [95% CI -1.20, -0.07], p<0.01), lip thickness (UL thickness: 2.27 [95% CI 1.79, 2.75], p<0.001; LL thickness: 0.41 [95% CI -0.16, 0.97], p<0.01), upper lip strain (UL strain: -2.68 [95% CI -3.32, -2.04], p<0.001) and soft tissue profile (N'-Sn-Pog': 2.68 [95% CI 1.87, 3.50], p<0.01). No significant difference was observed between the groups regarding skeletal changes in the maxilla and mandible, growth pattern, overjet, overbite, interincisal angle and soft tissue chin position (p>0.05). Premolar extraction treatment demonstrated significant intrusion-retraction of maxillary incisors, better maintenance of maxillary incisor inclination, and significant mandibular molar protraction; whereas functional treatment resulted in retrusive and intrusive effect on maxillary molars, marked proclination of mandibular anterior teeth, and significant extrusion of mandibular molars. Both treatment modalities had similar treatment duration. Implant failure was seen in 7.9% of cases, whereas failure of fixed functional appliance was observed in 9.09% of cases. Conclusions: Premolar extraction therapy is a better treatment modality, compared to fixed functional appliance therapy for Class II patients with moderate skeletal discrepancy, increased overjet, protruded maxillary incisors and protruded lips, as it produces better dentoalveolar response and permits greater improvement of the soft tissue profile and lip relationship.
RESUMO Objetivo: O objetivo desse estudo randomizado controlado paralelo de dois braços foi avaliar os efeitos do tratamento e as mudanças no perfil labial em pacientes esqueléticos Classe II submetidos a tratamento com extração de pré-molares (EP) versus tratamento funcional fixo (FF). Métodos: Quarenta e seis indivíduos que preencheram os critérios de inclusão foram distribuídos aleatoriamente em Grupo EP (idade média 13,03±1,78 anos) e Grupo FF (idade média 12,80±1,67 anos) (n=23 cada). O grupo EP foi tratado com extração dos primeiros pré-molares superiores e segundos pré-molares inferiores, seguida de fechamento do espaço com ancoragem em mini-implantes; e o Grupo FF, com tratamento usando aparelhos funcionais fixos. As alterações esqueléticas, dentárias e de tecidos moles foram analisadas usando cefalogramas laterais pré e pós-tratamento. Os dados obtidos desse estudo aberto foram submetidos a análise estatística cega. Resultados: O tratamento com extrações resultou em maior aumento do ângulo nasolabial (ANL: 3,1 [IC 95% 2,08, 4,19], p<0,001), melhora significativa do lábio superior (Ls-Linha E: -2,91 [IC 95% -3,54, -2,28], p<0,001, Ls-Linha S: -2,50 [IC 95% -2,76, -2,24], p<0,001, Ls-SnPog': -2,32 [IC 95% -2,90, -1,74], p<0,01) e posição do lábio inferior (Li-Linha E: -0,68 [IC 95% -1,36, 0,00], p<0,01, Li-Linha S: -0,55 [IC 95% -1,11, 0,02], p<0,01, e Li-SnPog': -0,64 [IC 95% -1,20, -0,07], p<0,01), espessura dos lábios (espessura Ls: 2,27 [IC 95% 1,79, 2,75], p<0,001; espessura Li: 0,41 [IC 95% -0,16, 0,97], p<0,01), tensão do lábio superior (tensão Ls: -2,68 [IC 95% -3,32, -2,04], p<0,001) e perfil de tecidos moles (N'-Sn-Pog': 2,68 [IC 95% 1,87, 3,50], p<0,01). Nenhuma diferença significativa foi observada entre os grupos quanto às alterações esqueléticas na maxila e mandíbula, padrão de crescimento, sobressaliência, sobremordida, ângulo interincisal e posição dos tecidos moles do mento (p>0,05). O tratamento com extração de pré-molares demonstrou significativa intrusão-retração dos incisivos superiores, melhor manutenção da inclinação dos incisivos superiores e protração significativa dos molares inferiores; enquanto o tratamento funcional resultou em efeito retrusivo e intrusivo nos molares superiores, proclinação acentuada dos dentes anteriores inferiores e extrusão significativa dos molares inferiores. Ambas as modalidades de tratamento tiveram duração de tratamento semelhante. A falha do mini-implante foi observada em 7,9% dos casos, enquanto a falha do aparelho funcional fixo foi observada em 9,09% dos casos. Conclusões: O tratamento com extração de pré-molares é uma modalidade de tratamento melhor do que os aparelhos funcionais fixos para pacientes Classe II com discrepância esquelética moderada, sobressaliência aumentada, incisivos superiores protruídos e lábios protruídos, pois produz melhor resposta dentoalveolar e permite maior melhora do perfil dos tecidos moles e relacionamento labial.
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Purpose: To compare outcomes of surgical management of uveitic glaucoma (UG) and steroid?induced glaucoma (SIG) in children in terms of intraocular pressure (IOP) control, visual acuity, and associations for failure. Methods: This was a retrospective case–control study of consecutive UG (cases) and non?uveitic SIG (controls) in children <18 years of age who underwent surgery between January 2005 and December 2017. Results: Primary trabeculectomy with mitomycin C (MMC) was performed in 12 cases (mean age: 9.2 ± 4.3 years) and 40 controls (mean age: 10.4 ± 3.7 years) (P = 0.33). Primary phaco?trabeculectomy with MMC was performed in 11 cases (mean age: 11.4 ± 4.7 years) and 16 controls (mean age: 10.4 ± 3.4 years) (P = 0.57). IOP control (P = 0.26), visual acuity (P = 0.97), number of glaucoma medications (P = 0.06), and survival rates (49% cases vs. 68% controls at 5 years; P = 0.22) were similar between the two groups following trabeculectomy. Survival rates in the phaco?trabeculectomy group at 5 years were 68% cases vs. 69% controls (P = 0.71). IOP was higher (P = 0.008) and visual acuity was worse (P = 0.02) in cases at the last visit. Associations for failure (univariate analysis) were younger age (OR: 6.29, 95% CL: 1.43, 27.67; P = 0.03) and male gender (OR: 4.79, 95% CL: 1.09, 20.97; P = 0.04). On multivariate analysis, younger age (OR: 11.985, 95% CL: 1.071, 134.153; P = 0.04) remained significant. Preoperative number of uveitic attacks was protective on univariate (OR: 0.75, 95% CL: 0.48, 1.15; P = 0.1) and multivariate analyses (OR: 0.49, 95% CL: 0.24, 0.09; P = 0.04). Conclusion: Outcomes of trabeculectomy between cases and controls were similar in our series. However, phaco?trabeculectomy in pediatric uveitic eye group fared worse than eyes with SIG.