Search

There are few studies comparing methods for pilonidal cyst closure. This study was conducted to compare simple surgical closure, secondary healing, and closure using a Limberg flap in the treatment of patients affected with pilonidal cysts. In total, 150 patients with pilonidal cysts were selected and randomized into 3 groups, with 50 participants in each group. Group A underwent primary closure, Group B underwent secondary closure, and Group C underwent closure with a Limberg flap. Operating time, amount of pain after surgery, time to mobilization, time until return to work, time for complete healing, time until being able to sit on the toilet without pain, postoperative complications including infection and recurrence, and seroma and edema after surgery were compared among the 3 groups. Duration of surgery in the Limberg flap group was significantly longer than the duration of surgery in Group A or Group B (p < .001). The time to patient mobilization, the time when the patient returned to work, the time to complete healing, and the time to being able to sit on the toilet without pain were significantly shorter in Group C than in Group A or Group B (p < .001). Although the procedure takes longer when using a Limberg flap, it appears to be a more effective method in the surgical treatment of patients with pilonidal cyst because of the reduced healing time and improved functional status after the procedure.

Traumatic brain injury (TBI) is a major cause of disability and death globally. Despite significant progress in neuromonitoring and neuroprotection, pharmacological interventions have failed to generate favorable results. We examined the effect of memantine on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage, and the Glasgow Coma Scale (GCS) in patients with moderate TBI. Patients were randomly assigned to the control group (who received standard TBI management) and the treatment group (who, alongside their standard management, received enteral memantine 30 mg twice daily for 7 days). Patients' clinical data, GCS, findings of head computed tomography, and serum NSE levels were collected during the study. Forty-one patients were randomized into the control and treatment groups, 19 and 22 patients respectively. Baseline characteristics and serum NSE levels were not significantly different between the 2 groups. The mean serum NSE levels for the memantine and the control groups on day 3 were 7.95 ± 2.86 and 12.33 ± 7.09 ng/mL, respectively (P = .05), and on day 7 were 5.03 ± 3.25 and 10.04 ± 5.72 ng/mL, respectively (P = .003). The mean GCS on day 3 was 12.3 ± 2.0 and 10.9 ± 1.9 in the memantine and control groups, respectively (P = .03). Serum NSE levels and GCS changes were negatively correlated (r = -0.368, P = .02). Patients with moderate TBI who received memantine had significantly reduced serum NSE levels by day 7 and marked improvement in their GCS scores on day 3 of the study., (© 2017, The American College of Clinical Pharmacology.)

Background: Omega-3 fatty acids carry major roles in mediating inflammation, immune response, lipid peroxidation and lipoprotein metabolism. Diversity of health benefits have been attributed to dietary supplementation with omega-3 fatty acids in transplant and nontransplant settings. Several studies in renal transplantation have suggested that supplementation with omega-3 fatty acids may lead to significant clinical benefits. However, the extents of these benefits are variable and published data had not coincided with positive findings., Objectives: The aim of this study was to evaluate the effectiveness of omega-3 supplementation on the lipid profile and lipid peroxidation in patients underwent kidney transplant., Patients and Methods: Thirty cases had been selected with stable allograft function following at least six months of transplantation. The serum levels of lipids including triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL), very low density lipoprotein (VLDL), total cholesterol and indices of lipid peroxidation (malondialdehyde and APO a1) were measured by biochemical techniques at the baseline. Two months following prescription of oral omega-3 (3 g/day), the biochemical measurements were repeated and the differences were analyzed., Results: Of thirty patients, 12 were male and 18 were female with the mean age of 45.3 ± 13.0 (18-65) years. At the baseline, the serum levels of MDA and APO B were 3.5 ± 1.3 and 148.3 ± 20.4 ng/dL respectively. At the end of two months following intervention, they were 3.2 ± 1.2 and 145.7 ± 19.0 ng/dL, respectively (P > 0.05). Correspondingly, at the baseline the serum levels of triglyceride, LDL, VLDL and total cholesterol were 171.1 ± 58.7, 106.9 ± 31.8, 42.2 ± 4.0, 145.7 ± 33.2 and 181.2 ± 35.1 mg/dL and after intervention they were 162.4 ± 82.5, 99.4 ± 35.1, 44.6 ± 6.3, 140.3 ± 33.1 and 170.9 ± 38.3 mg/dL, respectively (P > 0.05). There was no significant difference between the males and females in this instance., Conclusions: Our results seem to indicate that oral omega-3 may promote the lipid profile and indices of lipid peroxidation in patients following kidney transplantation however extents of these effects are not significant.