Abstract- This prospective study aims to determine the Factorsaffectingoutcome of Therapeutic Penetrating Keratoplasty and its role in the management of corneal diseases. Penetrating keratoplasty is the final therapeutic option in the management of refractory corneal disease after conventional medical therapy fails to prevent corneal perforation. (1)
Purpose: To evaluate outcome of interventional and surgical treatment in infrainguinal bypass occlusion and to identify predictive factorsaffecting therapeutic success. Material and Methods: Over a period of three years 96 patients with infrainguinal bypass occlusion were included in this retrospective study. 52 patients were treated by catheter-directed thrombolysis and 44 patients by reconstructive vascular surgery. Results: 41 grafts could be reopened in thrombolytic group (78.8%), thrombolysis failed in 11 cases (21.2%). 34 grafts were treated successfully by reconstructive vascular surgery (77.3%), 10 grafts couldn’t be reopened or reoccluded within 30 days after surgical therapy. After a median observation time of 14.7 months 30 of 48 (62.5%) bypass grafts treated with intraarterial thrombolysis and 19 of 27 (70.4%) grafts treated with thrombectomy were overall patent. Limb salvage was 81.3% in thrombolytic group and 88.8% in surgery group. No predictive factorsaffectingoutcome could be identified in both groups except the localiza- tion of the occluded graft (above/below knee). Conclusion: Infrainguinal bypass occlusion is a serious and challenging complication in vascular surgery. Our study showed similar results for both therapeutic strategies. Despite our data was retrospective with a small number of patients the localization of the occluded graft as predictive pre-therapeutic factor was significant in thrombolytic and surgery group. Based on these scientific findings we established a guideline for choice of therapeutic treatment in our institution after searching current literature.
This is to certify that this dissertation work titled “ A STUDY OF PREDICTORS AND FACTORSAFFECTINGOUTCOME IN DIABETIC KETOACIDOSIS ” of the candidate DR. SHAARON.S with registration Number 201511209 for the award of M.D in the branch of General Medicine. I personally verified the urkund.com website for the purpose of plagiarism Check. I found that the uploaded thesis file contains from introduction to conclusion pages and result shows 4% of plagiarism in the dissertation.
In this prospective study of determinants of factorsaffectingoutcome of perforated peptic ulcer disease,addiction with more than 1 substance ,creatinine >1.4 mg/dl,perforation size >1 cm,contamination >1000ml are important factors causing mortality was concluded in this study.
Methods: A hospital based retrospective observational study in which 51 patients who underwent cochlear implant surgery from July 2017 to January 2019 were evaluated at Dr. Babasaheb Ambedkar Memorial Hospital, Byculla, Mumbai using 3 parameters i.e. Revised CAP score (CAP), meaningful auditory integration scale (MAIS), speech intelligibility rating (SIR) at various intervals postoperatively and outcome was evaluated.
Purpose: To compare the clinical outcome and complica- tions following total knee arthroplasty (TKA) in diabetic and non-diabetic patients, and to identify diabetes-related risk factors for negative outcomes. Materials and Methods: 222 primary TKAs in patients with diabetes were evaluated using Knee Society scores and Hospital for Special Surgery score. Postoperative complications were reviewed retrospectively. The mean follow-up was 53.2 months. The effect of diabetes- related factors and comparison with a matched control group were analyzed statistically. Results: Significant improvements were noted in all the scores after TKA (p < 0.05). There was no statistical difference in clinical sores between the diabetic and non-diabetic patients. In multivariate analysis associating age, gender and body mass index with pain and knee score at the latest follow-up, the average knee scores in normal and overweight group were found to be significantly higher than those in the obese group. The diabetic patients had an increased overall incidence of postoperative complications (17.6%) compared with the control group (8.1%) (p < 0.05). Particularly, the rate of wound complications such as skin necrosis, bulla formation or erythema with drainage was higher in the diabetic group (p < 0.05). Diabetes-related factors did not influence the incidence of complications. Associated diseases were the only significant risk factors correlated with wound complications and meniscal bearing dislodgement. Conclusion: Patients with diabetes can benefit from TKA, even though diabetic patients are at an increased risk for overall postoperative and wound complications. Preoperative factors such as obesity and associated diseases may adversely affect the clinical outcome of TKA in diabetic patients.
Most common methods for labour induction especially with an unfavourable cervix include intra vaginal insertion of Dinoprostone (PGE2), prostaglandin E1 (PGE1) analogue Misoprostol or intra-cervical insertion of Foley catheter. Regardless of cervical status and parity, vaginal delivery can be anticipated in the majority of patients undergoing labour induction. To avoid potential risks associated with the procedure, the woman and her fetus need to be monitored closely. This can strain the limited health-care resources in under-resourced settings. This study was undertaken to identify the factors that affect the success and failure of induction of labour and thus to help improve quality of induction of labour and decrease unnecessary indications of the procedure. METHODS
The incidence of mastitis was, however, significant for most housing factors in this study; farms with tie-stall had significantly higher mastitis incidence than farms with loose stall, and a similar difference was seen between farms with insulated or uninsulated stalls. The higher mastitis incidence for cows housed in tie-stall might be caused by the lack of movement, i.e. lying on the same surface all day. This result is similar to previous studies, where it has been shown that cows housed in tie-stalls have a higher incidence of clinical mastitis compared to cows housed in loose stalls (Rodrigues et al., 2005; Gordon et al., 2013; Richert et al., 2013). Richert et al. (2013) discussed that it was likely that this difference was caused by pathogens in the bedding or by the indirect effect of the housing type on the cows’ hygiene. Furthermore, farms in this thesis where cows had access to an outdoor area had significantly higher mastitis incidence compared to farms without outdoor access. This could be caused by the increased exposure to dirt and bacteria outdoors, something that might increase the risk of mastitis. This was however not evident in a previous study by Popescu et al. (2013), where it was found that cows housed in tie-stall with access to an outdoor area for exercise had a lower mastitis incidence compared to cows that were housed in tie-stall without access to an outdoor area. However, no analysis between tie-stall farms with or without access to an outdoor area was done in this thesis, as there were too few farms with tie-stall to analyse, so it is not certain whether there was a difference in mastitis incidence between farms with the different tie-stall types in this thesis also. Nonetheless, studies on a cow level is needed to conclude the effect of outside access on factors such as mastitis incidence and SCC, especially from an organic management perspective.
Some references explained a special limitation for appropriate endometrial thickness for pregnancy (12). In ART cycles often we see a thin endometrium with few dominant follicles or a thick endometrium with one or two small follicle. The aim of this retrospective study was to determine the effect of some factors such as age, number of follicles and number of gonadotropin ampulse on the endometrial thickness and its impact on pregnancy in intrauterine insemination cycles.
Conversely, we could have underestimated the signifi- cance of the OTP program as the study was conducted during the lean season of the locality. As dietary diversity and household food insecurity were assessed retrospect- ively, recall errors cannot be fully excluded. Further, re- sponses related to RUTF sharing and selling behaviours might have been underestimated due to social desirability bias. In addition, baseline wasting status, which can be an important predictor of the treatment outcome in children with non-oedematous malnutrition was not statistically adjusted, and this may have limited the comprehensive- ness of the model and caused residual bias in the analysis. Due to the observational design of the study, confounding from unmeasured variables (e.g. vaccination history, birth weight) cannot be entirely excluded.
Distal femoral fractures are difficult to treat because they are often unstable and comminuted and have a potential for long term disability. Varus collapse, malunion and nonunion were the problems before fixed angle plates and indirect reduction techniques were introduced. In principle, therefore, all intra – articular distal femoral fractures should be treated surgically. Successful treatments of distal femoral fractures require surgery and maintenance of the congruence of the articular surfaces. The prognostic factor for supracondylar fracture includes age, intra articular involvement, method of treatment, timing of joint mobilization etc. Comparison of results with other studies is often difficult because of difference in the classifications schemes and the use of different methods of treatment [5-7] . Some articles have been published documenting superior functional results using internal fixation [8, 9] . Rigid fixation has also enabled earlier knee motion and weight bearing, which help prevent some of the serious complication attributed to prolonged bed rest and traction [5, 6] . In our study an attempt was made to assess the factorsaffecting functional outcome of distal femoral fractures with intra articular extension, treated by various surgical methods. The present study was conducted on 25 patients with supracondylar fracture with intra articular extension admitted in department of Orthopedics, in MGM Warangal, Hospital.
significant decrease in neonatal mortality can be anticipated with regionalization of perinatal care, where many sick newborns can be provided with better care and outcome if they are timely transported in stable condition. Individual morbidity and cause for mortality have not changed in developing countries though many of them can be managed properly. Perinatal asphyxia,
Obesity is a consequence of some genetic diseas- es also associated with infertility and has an ad- verse effect on male fertility (27). Male obesity is emphasized by physicians in the process of infer- tility treatment so as to facilitate the success of the treatment (OR=1.104 in Table 3). The cou- ple’s BMI, which is often negatively correlated with fertility outcomes (20, 28), was not a con- founding variable in the present study, as the mean BMI was normal in half of the women while others were only mildly overweight. Obesi- ty appears to have a greater adverse effect on fer- tility in men (28). In this study, only 5% of the men had a BMI above 33 and the increase in BMI increases the chances of success by 6%. Perhaps this interpretation is surprising at first glance, but 41% of men had BMI lower than normal level and 3% were obese. Thus the in- crease in BMI has brought men's weight closer to normal for achieving success. This justification has also been raised in MacDonald et al (29) in- vestigations. The interpretation needs to be more carefully considered as complementary research. In our research, family marriages (marriage with aunt or uncle's daughter) have not significant ef- fect on treatment success rate. Although research has been emphasized on the fate of pregnancy in family marriages by factors may activate immuno- logic or ambiguous factors (30).
One additional finding of our study was that PTB patients in treatment management model of full-course supervision and supervision in intensive phase had higher probability of treatment success. This is consist- ent with the study in China , which indicated that absence of a treatment observer was associated with unsuccessful outcome. It is also in conformity with the findings of a study in Brazil, which indicated that pa- tients who did not receive directly observed therapy were more likely to default from anti-TB treatment, die of TB and have unknown treatment outcomes . Our find- ings suggest that the treatment management model of supervision in intensive phase should be recommended for both new PTB+ and PTB- patients. Furthermore, un- like in other studies [7, 28], we could not find associa- tions between males and unsuccessful treatment. In addition, no association was found between treatment regimens and treatment outcomes, which is inconsistent with the study in Nigeria  where 2RHZE/6EH treat- ment was a predictor of unsuccessful outcome in HIV negative TB patients.
As has been reported, the funnel plots showed a relatively symmetric distribution, but the point cloud did not have a distinctive funnel form. This was probably due to the rel- atively high heterogeneity and to the small number of the primary studies included in the meta-analysis. Therefore a publication bias may have also occurred. This risk is implicit in all meta-analyses or review studies because it is easy to understand that original studies that show no ben- efit or worse outcome when comparing a new technique with usual care are less likely to be published [47,50]. Two of the included studies [34,42] reported the effects of the clinical pathway together with other hip/knee implant standardisation programmes, and Dowsey et al.  used pathways in association with a pre-admission informa- tion seminar for the patients, which could have further increased the statistical heterogeneity of the results. A ran- dom effects analysis was performed in order to control this heterogeneity and to increase the strength of the observed findings [51-53].
The way outcome in orthopedic trauma is being assessed is changing, shifting to patient focused outcome measures such as quality of life (QOL) and patient-reported outcome measures (PROMs) [23–25]. From 1985 to 2015, the number of studies on injured patients including PROMs increased almost 30-fold . PROMs, per the recommendations of the COSMIN group, should be valid, reliable, and responsive [26–28]. Today, various PROMs have been published, but we are still missing a universally applied gold standard . In this study, we applied the VAS-FA, Karlsson Score and SF-12, which were the standard PROMs used in our de- partment at that time.
In this study, we dissected both host and virus factors that can affect the clinical outcome of BTV infection. The use of a uniform experimental framework has allowed us to rigorously interrogate both experimental questions addressed in past studies (55), as well as to explore hitherto unanswered questions. First of all, as sug- gested previously (24, 32–36), we confirmed that while both sheep and goats are fully susceptible to BTV (in this case BTV-8) infec- tion, the former are more susceptible than goats and more likely to develop clinical disease. The levels of viremia in BTV-infected goats were not different from (if anything, higher than) those observed in infected sheep. These data confirm that BTV is able to replicate to high levels in goat tissues but cellular damage, either induced by the virus or the host immune responses, does not likely occur. We do not know if goats would be more susceptible to disease if we had used higher infectious doses. We have used 2 ⫻ 10 6 PFU of BTV in our experimental infections, and this is likely far more infectious virus than is transmitted in nature by infected midges. In addition, studies in sheep using as little as 10 1.4 TCID 50
Regarding timing of intervention, our study suggests that visual outcome is affected by age of intervention, etiology, and laterality. Traumatic cataracts did well with late interventions (age 11 - 18; Table 3). Patients in the non-traumatic group did well in the case of type 1 mor- phology if the intervention was early and in the case of type 2 morphology (partial opacity), if the intervention was late. In cases of unilateral cataracts, sooner is better. These findings were similar in the non-traumatic group . For the traumatic group, the interval between injury and intervention is important . On the other hand, their lens opacities were characteristic of congenital la- mellar cataracts , a type of cataract we have not found to be acquired postnatally in otherwise healthy children.
corrected visual acuity, average spherical equivalent and the degree of anisometropia. Although there is lack of agreement in these studies regarding the effect of these factors in on the outcome and the response to the surgical management of primary exotropia, most of them raised the importance of preoperative angle of deviation, and we found as others the importance of preoperative angle of deviation in determining the postoperative result & response to surgery. So improvement in the method of measuring preoperative angles of deviation would be expected to improve the final result. Some studies suggested measuring the angle of deviation after 30-60 minutes of monocular occlusion  or go to the largest measured angle. Delay surgery if possible to get accurate, stable measurement, especially some studies did not show better outcome with early surgery . Most recently, a study by Yam et al.  reported that the postoperative exodrift along three years occurs in a majority of patients after bilateral lateral rectus recession for intermittent exotropia. The long-term surgical success is significantly affected by this postoperative exodrift. Larger preoperative deviations are associated with a larger early and late postoperative exodrift. Also other study suggested that a significant refractive error such as high myopia should be taken into consideration when you are planning for surgery as the measured angle may be slightly higher than their true angle of deviation. So the effect of surgery on them would be less than surgery done in hyperopic patients . In conclusion, our study demonstrated the importance of preoperative angle of deviation and it correlates positively with the response to surgery. Therefore accurate measurements are necessary before surgery should be performed.
This is certify that this dissertation work title A CLINICAL STUDY OF THE FACTORSAFFECTING THE OUTCOME OF INTESTINAL RESECTION AND ANASTOMOSIS of the candidate Dr. AJAY ABRAHAM,MBBS., with registration Number 221511351 for the award of M.S. in the branch of GENERAL SURGERY. I personally verified the urkund.com website for the purpose of plagiarism check. I found that the uploaded thesis file contains from introduction to conclusion page and result shows 2 percentage of plagiarism in the dissertation.