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Surgical Treatment of Rhinogenic Contact Point Headache: An Experience from a Tertiary Care Hospital.

ABSTRACT: Introduction Even in the absence of inflammatory disease, facial pain often results from pressure of two opposing nasal mucosa surfaces. Objectives The objective of this study is to assess the efficacy of surgical treatment of contact point headache. Methods Our study enrolled patients with unilateral facial pain and without nasal/paranasal sinus disease. We confirmed the presence of mucosal contact by nasal endoscopy and by computed tomography. Forty-two subjects with the three most common anatomical variations underwent complete evaluation: 17 with concha bullosa (CB), 11 with septal deviation (SD), and 14 with septal spur (SS). All participants were treated by topical corticosteroid, adrenomimetic, and antihistamine. The patients without improvement were treated surgically. We assessed the severity of pain using a Visual Analogue Score (VAS) before surgical treatment and one, six, twelve, and twenty-four months after. Results The patients with SS had more severe facial pain in comparison with patients with CB (p = 0.049) and SD (p = 0.000). The subjects with CB had higher degree of facial pain than the ones with SD (p = 0.001). After an unsuccessful medical treatment and surgical removal of mucosal contacts, the decrease of headache severity was more intense in patients with CB and SS (p = 0.000) than in the patients with SD (p = 0.01). Conclusion Our results suggest that topical medications have no effects and that surgical removal of mucosal contacts could be effective in the treatment of contact point headache. The results of surgical treatment were better in cases of facial pain caused by SS and CB, than in those caused by SD.

SUBMITTER: Peric A

PROVIDER: S-EPMC4835330 | biostudies-other | 2016 Apr

REPOSITORIES: biostudies-other

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Project description:Objective:Although numerous studies have assessed patient satisfaction in diverse settings, in the realm of nursing surgical care, standardization of measurement for patient experience and satisfaction is lacking. Therefore, the aim of this study was to assess the satisfaction of surgical patients with perioperative nursing care. Method:A descriptive cross-sectional survey was conducted. Sociodemographic characteristics and clinical data were recorded. Patient satisfaction was measured with a modified version of the La Monica-Oberst Patient Satisfaction Scale (LOPSS-12). Results:150 patients (73 women, 49% and 77 men; 51%) completed the survey. The mean age was 63?years (standard deviation, 16?years). The mean overall satisfaction score on the La Monica-Oberst Patient Satisfaction Scale was 3.17 (standard deviation, 0.21). The scale showed adequate content validity (Lawshe's Content Validity Index was 0.76) and moderate reliability (Cronbach's alpha?=?0.70). Two variables-patient sex and the presence of comorbidities-were significantly associated with overall satisfaction: men and patients with comorbidities were more satisfied with the care received. Patients with university studies were significantly more likely than patients with less education to consider nurses "impatient," but also considered the nurses' advice to be "useful." Patients with hospital-acquired complications were more likely to perceive nurses to be "more interested in completing tasks than in listening," although they also felt that nurses worked "conscientiously." Conclusion:Overall, patient satisfaction with perioperative nursing care was good. This study identified several areas of nursing care in need of improvement, particularly the need to spend more time with patients and to keep them better informed about the perioperative process. The modified La Monica-Oberst Patient Satisfaction Scale is suitable for measuring surgical patient satisfaction with perioperative nursing care. The findings presented here may be of value to nursing administrators, educators, and nursing care providers to improve patient satisfaction and to develop strategies to prevent patient dissatisfaction.

Project description:BackgroundThe disability of stroke patients remains an important global health problem; yet information on the extent of restriction from basic and instrumental activities of daily living is limited, particularly in lower-and middle-income (LMIC) countries. Therefore, we examined the issue under the caption, since it is the first step in planning several rehabilitation services.MethodA facility-based cross-sectional study was done to assess the magnitude and predictors of post-stroke limitations in basic activities of daily living (BADL) using the Barthel Index (BI) scale and instrumental activities of daily living (IADL) using the Frenchay Activities Index (FAI) scale among patients who visited Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, Neurology Clinic from April-October, 2022. All patients having a diagnosis of stroke for more than six months duration were enrolled. Descriptive and inferential statistical analyses were done, and measures of estimated crude and adjusted odds ratio with 95% CI were constructed and a p-value less than 0.05 was considered statistically significant. The results are presented in figures and tables.ResultsA total of 150 stroke patients were enrolled in the present study. The mean age of participants was 53 (14.9) years with slight male preponderance (51.3%). Ischemic stroke was present in 106 (70.7%) of them, while 44 (29.3%) had hemorrhagic stroke. Of this, 57 (38%) and 115 (79.3%) of them had limitations in basic and instrumental ADL, respectively. Comorbid cardiac disease (AOR = 6.9; 95%CI = 1.3-37.5) and regular substance use (AOR = 11.1; 95%CI = 1.1-115) were associated with limitations in BADL, while an increase in age (AOR = 1.1; 95%CI = 1.04-1.15) was associated with severe limitations in BADL. Initial stroke severity (AOR = 7.3; 95%CI = 1.2-44.7) was associated with limitations in IADL, whereas depression (AOR = 5.1; 95%CI = 1.1-23.2) was identified as a predictor of severe limitation in IADL.ConclusionLimitation in activities of daily living (ADL) after stroke is common among Ethiopian patients. Therefore, screening for post-stroke limitations in daily activities is essential for further management and rehabilitative plans.

Project description:BackgroundThe value of early integration of palliative care has been demonstrated increasingly for the past years in both oncological and nononcological diseases. Outpatient palliative care services might represent a feasible approach to implement supportive care in early disease. In this study, we aimed at evaluating which patients use and benefit from outpatient palliative care services, which symptoms are addressed most, and which support services are installed in this early phase of disease.MethodsWe retrospectively analyzed the entire patient collective of a recently developed palliative care outpatient clinic within the leading university hospital in Switzerland for a period of five years. Sociodemographics, symptoms, and information on disease as well as patient-reported outcomes were retrieved from the electronic patient files. Demographic and clinical data were analyzed by descriptive statistics between groups and survival was analyzed by means of Kaplan-Meier estimates and log-rank test.ResultsWe report on 642 consultations of 363 patients between 2016 and 2020. Patients had a mean of 1.8 visits (range 1-10), with n = 340 patients (93.7%) of patients suffering from an oncological disease. Overall symptom load was high, with n = 401 (73.7%) of patient-reported outcomes reporting two or more symptoms. Distress levels of 5 or higher were reported in n = 78 (30.4%) of available patient-reported outcomes. Independent of the origin of primary disease and the length of the disease trajectory, patients were referred to the palliative care service in median only four months before death.ConclusionWe identify high symptom load and distress in the outpatient palliative patient population. Patients benefitted from supportive medication, improvement of ambulatory support systems and advance care planning, and more than one-third of patients remained in follow-up, indicating a good acceptance of the service. Overcoming the overall late referral could, however, further increase the quality of life at earlier stages of disease.

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Surgical Treatment of Rhinogenic Contact Point Headache: An Experience from a Tertiary Care Hospital.

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