Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology.

Objectives: To evaluate overtreatment with the 'see-and-treat' approach in patients with high-grade squamous cervical cytology, and identify the clinical factors associated with overtreatment. Study design: Patients with high-grade squamous intra-epithelial lesion (HSIL) cytology undergoing colposcopy and loop electrosurgical excision procedure (LEEP) in a single visit or the 'see-and-treat' approach from January 2005 to December 2019 were reviewed retrospectively. The overtreatment rate and complications following LEEP were explored. Results: In total, 220 cases were identified. The overtreatment rate was 11.4%, and surgical complications were haemorrhage (n = 3, 1.36%) and infection (n = 9, 4.09%). On univariable analysis, factors associated with overtreatment were current cytological result and colposcopic impression. On multi-variable analysis, current cytological result of non-HSIL compared with HSIL/cancer, and colposcopic diagnosis of low-grade lesion or normal compared with high-grade lesion or cancer had adjusted odds ratios of 13.81 [95% confidence interval (CI) 1.23-155.20; p = 0.033] and 3.58 (95% CI 1.32-9.74; p = 0.013), respectively. Conclusions: The overtreatment rate with the 'see-and-treat' approach was 11.4%. Independent factors associated with overtreatment were current cervical cytological result of non-HSIL, and low-grade or normal colposcopic diagnosis.

Postoperative hormonal treatment for prevention of endometrioma recurrence after ovarian cystectomy: a systematic review and network meta-analysis.

BACKGROUND: The efficacy of hormonal regimens for the prevention of endometrioma recurrence in women who have undergone conservative surgery is still controversial. OBJECTIVE: To compare the efficacy of different hormonal regimens in this context and to rank them. SEARCH STRATEGY: MEDLINE and Scopus databases were searched through January 2020. SELECTION CRITERIA: Randomised controlled trials (RCTs) or cohorts, comparing the effect of any pair of interventions (i.e. cyclic oral contraceptives [OC], continuous OC, gonadotropin-releasing hormone agonist [GnRHa], dienogest [DNG], levonorgestrel-releasing intrauterine system [LNG-IUS] and expectant management) on endometrioma recurrence were selected. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two reviewers. Relative treatment effects were estimated using network meta-analysis (NMA) and ranked in descending order. MAIN RESULTS: Six RCTs (675 patients) and 16 cohorts (3089 patients) were included. NMA of the RCTs involving expectant management, cyclic OC, continuous OC, GnRHa and GnRHa + LNG-IUS, showed that all hormonal regimens had a nonsignificant lower risk of endometrioma recurrence compared with expectant management. NMA of the cohorts involving expectant, cyclic OC, continuous OC, GnRHa, DNG, LNG-IUS, GnRHa + OC, and GnRHa + LNG-IUS indicated that LNG-IUS, DNG, continuous OC, GnRHa + OC and cyclic OC had a significantly lower risk of endometrioma recurrence than expectant management. LNG-IUS was ranked highest, followed by DNG and GnRHa + LNG-IUS. Long-term use of hormonal treatment either OC or progestin had a significantly lower risk of endometrioma recurrence than expectant treatment. CONCLUSION: In the NMA of RCTs, there was no evidence supporting hormonal treatment for postoperative prevention of endometrioma recurrence. This was at odds with the cohort evidence, which found the protective effect of OC and progestin regimens, especially long-term treatment. Large-scale RCTs of these agents are still required. TWEETABLE ABSTRACT: Hormonal regimens given as long-term treatment tend to reduce risk of endometrioma recurrence after conservative surgery.

Wooden foreign body in the orbital cavity: a case report.

Orbital foreign bodies in Thailand are uncommon. The diagnosis depends on history taking, physical examination and complete investigations. A case of orbital foreign body was reported with satisfactory result of treatment by transethmoidal approach: ethmoidectomy with antrostomy.

The scarless rhytidectomy incision in superficial parotidectomy.

Post-operative scars usually occur at the incision sites following various procedures of the parotid gland surgery. From 1982 to 1996, 201 cases of scarless rhytidectomy incisions were analysed and reported, with satisfactory results.

A comparison of the incidence of post operative bleeding between electric cauterization and suture ligation tonsillectomies.

Two-thousand one-hundred tonsillectomies performed from January 1980 to December 1995 by otolaryngologists at Pramongkutklao General Hospital were reviewed. The Dissection-Tyding snare technique was used and hemostasis completed by electric cautery in 690 cases, by suture ligature in 720 cases, by gauze packing alone as a control in 600 cases respectively. It can be concluded that the use of suture ligature offers an efficient and practical method to reduce the incidence of primary tonsillectomies bleeding.

Hearing impairment in Thais due to sport shooting: a preliminary report.

Ninety one sportshooters from several sportshooting clubs ranging in age from 20-49 and 85 control subjects were carefully examined for hearing ability. The male and female ratio was 10.37:1. It was found that 9.34 per cent of the subjects were suffering from hearing impairment at the level of 3,000-8,000 Hertz. At most frequencies the mean decibel between the groups of shooters (1-5 years, 5-10 years, more than 10 years) was significantly different, with the right ear being significantly more impaired than the left ear (alpha = 0.1). At all frequencies the mean decibel level for the control group was significantly different from that for the sportshooters (alpha = 0.1). In conclusion, it is the responsibility of the National Environmental Board on Noise Pollution, the Royal College of Otolaryngologists of Thailand and other related organizations should be much more aggressive in educating sportshooters with regard to protecting their ears against acoustic trauma.