Role Of CO2 Laser & Microdebrider In The Treatment Of Juvenile Onset Recurrent Respiratory Papillomatosi.

OBJECTIVE: To compare the efficacy of two main treatment modalities of microdebrider and carbon dioxide laser excision for juvenile onset recurrent respiratory papillomatosis. Methods: The retrospective study was conducted in May 2021 at the Combined Military Hospital, Kharian, Pakistan, and comprised data from July 1, 2007, to January 31, 2020, of patients of either gender aged 2-12 years who were treated for juvenile onset recurrent respiratory papillomatosis either with microdebrider excision in group A or carbon dioxide laser excision in group B. Extent and severity of disease was documented as per the Derkay-Coltrera grading system. Data was analysed using SPSS 20. RESULTS: Of the 39 patients, 23(59%) were girls and 16(41%) were boys. The overall mean age at the time of procedure was 6.62±2.06 years. Group A had 22(56.4%) subjects; 15(68.2%) girls and 7(31.8%) boys, while group B had 17(43.6%) cases; 8(47%) girls and 9(53%) boys. The mean operative time for group A was 40.91±11.50 minutes and for group B it was 60.59±19.51 minutes. Postoperative breathing and oedema status was better for group A (p<0.05), while there was no significant difference regarding postoperative pain, residual disease and repeat surgeries (p>0.05). CONCLUSIONS: Microdebrider was found to be superior to carbon dioxide laser excision in the treatment of juvenile onset recurrent respiratory papillomatosis.

A Novel Technique for Thyroplasty Type 1, With Prolene Mesh Implant.

OBJECTIVE: To analyze the efficacy of a modified approach to thyroplasty type one using prolene mesh implant. STUDY DESIGN: Interventional study. PLACE AND DURATION OF STUDY: Combined Military Hospital Kharian, Pakistan, in Ent department, from July 2020 to Jan 2021. METHODOLOGY: Medialization thyroplasty with prolene mesh was performed on the patients satisfying the inclusion criteria. They were analyzed objectively as well as subjectively in terms of Mean Maximum phonation time, maximum word count, and visual analog score about the quality of voice. Data analysis was done with SPSS version 20. Pre-operative and post-operative records were compared using paired sample t-test. RESULTS: A total of 39 patients underwent vocal cord medialization with prolene mesh implant. The Mean age for medialization was 41.09 + 13.37. 23 patients were females and 15 were males. 26 patients had unilateral and 13 patients had bilateral vocal dysfunction. 18 of them had vocal dysfunction due to thyroidectomy, eight had idiopathic causes and 13 had miscellaneous. The improvement in mean visual analog score was 2.87 postoperatively. Median maximum phonation time increased about five seconds postoperatively, seven seconds in males, and 4.5 seconds for females. The maximum word count increased from 11.33 preoperatively to 18.28 postoperatively. There were no major complications observed in our study. CONCLUSION: These results were comparable to many other studies for vocal cord medialization with different implant materials. But prolene mesh implant offers an easily available yet cost-effective alternative with similar benefits. LEVEL OF EVIDENCE: III (Treatment benefits: Non-randomized controlled cohort/follow-up study).

MiR-21 in the Cancers of the Digestive System and Its Potential Role as a Diagnostic, Predictive, and Therapeutic Biomarker.

MicroRNAs (miRNAs) are small non-coding RNAs. They can regulate the expression of their target genes, and thus, their dysregulation significantly contributes to the development of cancer. Growing evidence suggests that miRNAs could be used as cancer biomarkers. As an oncogenic miRNA, the roles of miR-21 as a diagnostic and prognostic biomarker, and its therapeutic applications have been extensively studied. In this review, the roles of miR-21 are first demonstrated via its different molecular networks. Then, a comprehensive review on the potential targets and the current applications as a diagnostic and prognostic cancer biomarker and the therapeutic roles of miR-21 in six different cancers in the digestive system is provided. Lastly, a brief discussion on the challenges for the use of miR-21 as a therapeutic tool for these cancers is added.

An Overview of Algorithms and Associated Applications for Single Cell RNA-Seq Data Imputation.

Single cell RNA-Seq technology enables the assessment of RNA expression in individual cells. This makes it popular in experimental biology for gleaning specifications of novel cell types as well as inferring heterogeneity. Experimental data conventionally contains zero counts or dropout events for many single cell transcripts. Such missing data hampers the accurate analysis using standard workflows, designed for massive RNA-Seq datasets. Imputation for single cell datasets is done to infer the missing values. This was traditionally done with ad-hoc code but later customized pipelines, workflows and specialized software appeared for this purpose. This made it easy to benchmark and cluster things in an organized manner. In this review, we have assembled a catalog of available RNA-Seq single cell imputation algorithms/workflows and associated softwares for the scientific community performing single-cell RNA-Seq data analysis. Continued development of imputation methods, especially using deep learning approaches, would be necessary for eradicating associated pitfalls and addressing challenges associated with future large scale and heterogeneous datasets.

Results of carbon dioxide laser-assisted posterior cordotomy in cases of bilateral vocal cord paralysis: An analysis of 34 casest.

Carbon dioxide laser-assisted posterior cordotomy (LAPC) is an effective technique for the treatment of Bilateral Vocal Cord Paralysis (BVCP). For our case series we included 34 patients of BVCP from combined military hospitals of Rawalpindi, Lahore, Malir and Quetta and compiled the results of carbon dioxide LAPC which they underwent under general anesthesia between December 2009 to January 2017. Assessment of voice quality and breathing difficulty was carried out before and six weeks after the operation and graded according to scales. The complications after surgery were also noted. In the study, there were 10 (29.4%) males and 24 (70.6%) females. The mean age of the sample was 39.1 } 13.2 years. Overall, there was an improvement in breathing and mild worsening of voice quality after LAPC. The common complications after LAPC were dysphagia, revision surgery, and post-operative pain in 11.8%, 17.6%, and 17.6% respectively. The study concluded that carbon dioxide LAPC was associated with an improvement in breathing but resulted in a poor voice quality among patients with BVCP, along with a few side effects.

Paramedic self-reported exposure to violence in the emergency medical services (EMS) workplace: a mixed-methods cross-sectional survey.

INTRODUCTION: Studies from Australia, Sweden, the United States, and elsewhere have found that paramedics experience violence in the emergency medical services (EMS) workplace. The objective of this study was to describe and explore violence experienced by paramedics in the ground ambulance setting, including types of violence experienced, by whom the violence was perpetrated, actions taken by paramedics, and effects of these episodes. METHOD: A cross-sectional study utilizing a mixed-methods paper survey was provided to a convenience sample of rural, suburban, and urban-based ground ambulance paramedics in two Canadian provinces. Paramedics were asked to describe episodes of verbal assault, intimidation, physical assault, sexual harassment, and sexual assault they were exposed to during the past 12 months. Qualitative questions inquired about the impact of these experiences. Response selections were analyzed using descriptive statistics and regression analysis, and qualitative data was analyzed using descriptive content analysis. RESULTS: A total of 1,884 paramedics were invited to participate and 1,676 responded (89.0%). Most participants (75%) reported experiencing violence in the past 12 months. The most common form of violence reported was verbal assault (67%), followed by intimidation (41%), physical assault (26%), sexual harassment (14%), and sexual assault (3%). Patients were identified as the most common perpetrators of violence. Serious sequellae were qualitatively reported. CONCLUSION: The majority of Canadian paramedics surveyed experience violence in the workplace, which can lead to serious personal and professional sequellae. Strategies should be devised and studied to reduce violent events toward paramedics and to mitigate the impact such events have on the wellbeing of paramedics.