Does the eversion technique have a lower early postoperative stroke rate than the conventional technique in carotid endarterectomy?

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In carotid surgery, Does the eversion technique (ECEA) has an early postoperative lower stroke rate, As compared to conventional carotid endarterectomy (CCEA)? The outcome assessed was the stroke rate in the early potoperative period (30 days) in the two techniques. The best evidence confirmed that there is no statistically significant difference between ECEA and CCEA regarding the early postoperative stroke incidence.

The survival rate among endovascular and open surgical repair of abdominal aortic aneurysms.

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with Infrarenal abdominal aortic aneurysm (AAA), Does endovascular abdominal aortic repair (EVAR), AS compared to open surgical repair (OSR), has higher Survival rates? The outcomes assessed were the overall survival rates in both techniques. The best evidence showed that there is no statistically significant difference between EVAR and OSR in survival rates.

Incidence of anal incontinence among patients with anal fissure treated with Botox injection versus lateral sphincterotomy.

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with anal fissure, which technique has a lower of incidence anal incontinence: Botox injection or lateral sphincterotomy? The best evidence showed that Botox injection has lower incidence of incontinence.

Effects of longitudinal pavement edgeline condition on driver lane deviation.

Single vehicle crashes, particularly those classified as run-off-the-road, are very common on two-lane rural highways. One method to potentially reduce such crashes is to provide additional driver information in the form of wider longitudinal edgeline pavement markings. However, since these markings deteriorate over time, the primary objective of this research was to study the effects of longitudinal edgeline pavement markings with varying deterioration levels and widths and to assess a driver's ability to maintain lane position. The University of Idaho's driving simulator was used to examine these effects by incorporating different marking deterioration percentages and roadway geometries on a two-lane rural highway environment. Two different pavement marking widths (4 and 6 inch) and four different deterioration levels (0%, 25%, 50%, and 75%) were assessed in daytime and nighttime conditions as part of this study. The results determined that while wider 6-in longitudinal edgeline pavement markings compared with standard four inch edgeline markings did not cause any significant changes in driver lane deviation during the day, statistically significant differences were observed in nighttime driving conditions. Drivers consistently maintained a lane position that slightly favored the edgeline side throughout the study and increasingly shifted away from the centerline as edgeline deterioration worsened.

Potential crash reduction benefits of shoulder rumble strips in two-lane rural highways.

This paper reports the findings from a study aimed at examining the effectiveness of shoulder rumble strips in reducing run-off-the-road (ROR) crashes on two-lane rural highways using the empirical Bayes (EB) before-and-after analysis method. Specifically, the study analyzed the effects of traffic volume, roadway geometry and paved right shoulder width on the effectiveness of shoulder rumble strips. The results of this study demonstrate the safety benefits of shoulder rumble strips in reducing the ROR crashes on two-lane rural highways using the state of Idaho 2001-2009 crash data. This study revealed a 14% reduction in all ROR crashes after the installation of shoulder rumble strips on 178.63miles of two-lane rural highways in Idaho. The results indicate that shoulder rumble strips were most effective on roads with relatively moderate curvature and right paved shoulder width of 3 feet and more.

Role of immunoglobulin E and gastro-esophageal reflux disease in the development of otitis media with effusion.

INTRODUCTION: The role of allergy in chronic otitis media with effusion (OME) is controversial. AIM OF THE WORK: To study the role of allergy and gastroesphogeal reflux diseases in the etiology of OME. MATERIALS AND METHODS: It is a prospective study that was done on 43 cases; 30 patients suffer from OME with mean age 6.8 years and 13 control child with mean age 8.3 years. Blood sample were taken from patients and control children for assay of total Immunoglobulin E (IgE) and serum pepsinogen 1 (PG1). Effusion fluid samples were taken from middle ear of the patients during myringotomy and ventilation tube insertion; IgE and PG1 were assayed in the effusion samples. Total IgE and PG1 were assayed by enzyme-linked immunosorbent assay. RESULTS: Our results showed that, there is a correlation between serum IgE and Effusion IgE in the patients group, there is a significant negative correlation between PG1 in the effusion and serum of the studied patients. CONCLUSION: Allergy is a possible risk factor for the development of OME. The level of PG1in the effusion is one tenth of its level in the serum of the patients.

One month outcome of ocular related emergencies in a tertiary hospital in Central Saudi Arabia.

OBJECTIVE: To investigate the number and characteristics of patients attending the Accident/Emergency (A/E) Department of a tertiary care hospital in Riyadh, and to determine their route of referral, and pattern of ocular emergency cases. METHODS: A retrospective study was carried out using the records and history of all patients attending the A/E at King Abdulaziz University Hospital (KAUH) in Riyadh, Kingdom of Saudi Arabia in July 2010. Data collected included time of arrival, age, gender, source of referral, principal diagnosis, attending doctor, action taken, and discharge plan. RESULTS: A total of 1,412 patients were recruited in our study with an average daily attendance of 47 patients. A total of 863 (61%) patients were male, and their mean age was 28.2 years. The most frequent diagnosis in patients was trauma (382, 27%), followed by conjunctivitis (211, 14.9%), lids and lacrimal system (133, 9.4%), retina problems (51, 3.6%), glaucoma (30, 2.1%), neuro-ophthalmology (22, 1.6%), keratitis (20, 1.4%), uveitis (10, 0.7%), and episcleritis (5, 0.35%). Most cases (77.5%) seen were self-referrals. Additionally, 712 (50.4%) of cases were considered as non-emergency, which are visiting the A/E for dry eye, chalazion, blepharitis, and allergy. CONCLUSION: Most cases seen at our ophthalmic A/E had non-urgent conditions that could be managed satisfactorily by trained ophthalmic assistants under supervision of an ophthalmologist.