Fibrin Glue Injection a Promising Option in the Treatment of Patients with Anal Fistula

Background: Fistula in ano is a public perianal illness and as a long-lasting inflammatory illness which does not cure naturally. There are several surgical procedures for treatment of fistula in ano, but these surgical interventions have little degrees of success, long time of wound healing after surgery and prolonged pain, especially in complex and difficult fistulas are observed. Novel sphincter-saving methods have been used in the management of perianal fistula in order to evade the risk of fecal incontinence. Among them, the fibrin adhesive method is popular because of its ease and repeatability. Objective: The objective of the present study is to evaluate the effect of fibrin-glue injection in the treatment of anal fistula (low/high as well as primary/secondary). Method: A prospective, planned experiment was conducted on 322 patients who were established to have fistulas in ano. They were assessed by sorting them into high fistula (172/322) and low anal fistula type (150/322). The fibrin glue was instilled in their anal tracts. The character of the anal tract, whether it was simple or complex and primary or secondary, was analyzed. The outcome in terms of a postoperative discharge (failure) was noted at 3 months, 6 months, 9 months, 1 year, and 2 years. Results: Total 322 patients were involved in this study. The general success rate was 275/322 (85.4%) after a mean follow-up of 1.5 years. All patients with a complex fistula (for low/high fistula, primary/secondary) had failure of healing (success rate 0%) either through first or second injection of fibrin-glue while all patients with simple fistula had successive rate of healing (for low/high fistula, primary/secondary) either through first or need the second injection of fibrin-glue. None of the patients had postoperative continence problems, and no other complications were noted. Conclusion: Fibrin glue is a novel attractive approach, easy, safe, minimally invasive, repeatable and cost effective for treatment of anal fistula simple (low/high and primary/secondary) and promising option for treatment of high fistula, and do not have a role for healing the complex anal fistula.

Neuromodulation for tinnitus treatment: an overview of invasive and non-invasive techniques / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Tinnitus is defined as a perception of sound without any external sound source. Chronic tinnitus is a frequent condition that can affect the quality of life. So far, no causal cure for tinnitus has been documented, and most pharmacologic and psychosomatic treatment modalities aim to diminish tinnitus’ impact on the quality of life. Neuromodulation, a novel therapeutic modality, which aims at alternating nerve activity through a targeted delivery of a stimulus, has emerged as a potential option in tinnitus treatment. This review provides a brief overview of the current neuromodulation techniques as tinnitus treatment options. The main intention is to provide updated knowledge especially for medical professionals counselling tinnitus patients in this emerging field of medicine. Non-invasive methods such as repetitive transcranial magnetic stimulation, transcranial electrical stimulation, neurofeedback, and transcutaneous vagus nerve stimulation were included, as well as invasive methods such as implanted vagus nerve stimulation and invasive brain stimulation. Some of these neuromodulation techniques revealed promising results; nevertheless, further research is needed, especially regarding the pathophysiological principle as to how these neuromodulation techniques work and what neuronal change they induce. Various studies suggest that individually different brain states and networks are involved in the generation and perception of tinnitus. Therefore, in the future, individually tailored neuromodulation strategies could be a promising approach in tinnitus treatment for achieving a more substantial and longer lasting improvement of complaints.

Neuromodulation for tinnitus treatment: an overview of invasive and non-invasive techniques / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Tinnitus is defined as a perception of sound without any external sound source. Chronic tinnitus is a frequent condition that can affect the quality of life. So far, no causal cure for tinnitus has been documented, and most pharmacologic and psychosomatic treatment modalities aim to diminish tinnitus' impact on the quality of life. Neuromodulation, a novel therapeutic modality, which aims at alternating nerve activity through a targeted delivery of a stimulus, has emerged as a potential option in tinnitus treatment. This review provides a brief overview of the current neuromodulation techniques as tinnitus treatment options. The main intention is to provide updated knowledge especially for medical professionals counselling tinnitus patients in this emerging field of medicine. Non-invasive methods such as repetitive transcranial magnetic stimulation, transcranial electrical stimulation, neurofeedback, and transcutaneous vagus nerve stimulation were included, as well as invasive methods such as implanted vagus nerve stimulation and invasive brain stimulation. Some of these neuromodulation techniques revealed promising results; nevertheless, further research is needed, especially regarding the pathophysiological principle as to how these neuromodulation techniques work and what neuronal change they induce. Various studies suggest that individually different brain states and networks are involved in the generation and perception of tinnitus. Therefore, in the future, individually tailored neuromodulation strategies could be a promising approach in tinnitus treatment for achieving a more substantial and longer lasting improvement of complaints.

Customized Alar Stent Fabrication for Atrophic Rhinitis Patient: A Non-invasive Technique.

Atrophic Rhinitis is a form of chronic rhinitis in which the nasal mucosa atrophies and hardens; eventually causing the nasal passages to dilate and dry out. Other prominent findings include foul smelling crusts and bleeding. Despite various local, medical and surgical methods suggested for the treatment of this slowly progressing disease, the problem with respect to the proper maintenance of the nasal valve area remains unsolved. The alar stent prevents the narrowing of the nostrils and helps in maintaining the airway patency. This article describes a simplified, non-invasive technique for the fabrication of a heat polymerized clear acrylic resin alar stent for treating the atrophic rhinitis patient.

Comparative evaluation of marginal integrity of glass ionomer and resin based fissure sealants using invasive and non-invasive techniques: An in vitro study.

Background: Occlusal surfaces of the molars are highly susceptible to dental decay. Pit and fissure sealants are one of the best methods of preventing fissure caries. The main problem encountered is microleakage leading to deterioration of material and increased possibility of the development of secondary caries. Aims: To assess and compare the marginal integrity of glass ionomer (Fuji VII) and resin based (Clinpro) fissure sealants using invasive and non-invasive technique. Setting and Design: Experimental in-vitro study. Materials and Methods: An in-vitro study was conducted on 40 healthy, extracted premolars. The teeth were divided into 4 groups. Group I: Clinpro-invasive technique, group II: Clinpro-non-invasive technique, group III: Fuji VII-invasive technique, group IV: Fuji VII-non-invasive technique. Sealants were applied and subjected to an evaluation under SEM (scanning electron microscopy) for the width of the marginal gap. ANOVA (analysis of variance) and Duncan's multiple range tests were used for the statistical analysis. Results: The mean width of the marginal gap was 0.4089 μm in group I as compared to 3.0485 μm in group III; and the difference was statistically highly significant (P<0.001). In non-invasive technique, Clinpro and Fuji VII showed a mean marginal gap width of 0.4486 μm and 3.0485 μm, respectively. This difference was statistically highly significant at a P<0.001. There was no statistically significant difference in the mean widths between invasive and non-invasive techniques. Conclusion: Clinpro performed better in terms of marginal adaptation than did the Fuji VII sealant. The techniques (Invasive and non-invasive) does not influence the marginal integrity significantly.