Introduction: Knee deformity associated with osteoarthritis (OA) is one of the most common complications seen in patients referred to orthopaedic surgeons. High tibial osteotomy (HTO) is an accepted method for treatment of medial knee osteoarthritis with varus deformity. The aim of this study was to compare results of osteotomy methods in patients with genu varum (GV) deformity. Methods: In this cohort study, the sample consisted of 32 patients with genu varum deformity (42 knees) who were divided into two groups and matched according to age and gender. The patients were treated with open or closed wedge osteotomy. After surgery, they were followed-up and compared for 6 months. Results: The sample consisted of 25 women (87.2%) and 7 men (21.8%). Ten patients (31.2%) presented with bilateral deformity. The incidence of complications was the same for both procedures (12.5%); this included one peroneal nerve injury following closed wedge surgery. Overall, patient satisfaction was 87.5% and 75% for the open and closed wedge methods respectively. Operative time, days to full weight bearing, and days to return to routine activities were significantly shorter for patients treated with the open wedge method (p<0.001). Conclusion: Open wedged HTO is associated with shorter operating time, shorter recovery time, higher patient satisfaction, and probable lower risk of neurological injury.

Swallowing induces an inhibitory wave that is followed by a contractile wave along the esophageal body. Deglutitive inhibition in the skeletal muscle of the esophagus is controlled in the brain stem whilst in the smooth muscle, an intrinsic peripheral control mechanism is critical. The latency between swallow and contractions is determined by the pattern of activation of the inhibitory and excitatory vagal pathways, the regional gradients of inhibitory and excitatory myenteric nerves, and the intrinsic properties of the smooth muscle. A wave of inhibition precedes a swallow-induced peristaltic contraction in the smooth muscle part of the human oesophagus involving both circular and longitudinal muscles in a peristaltic fashion. Deglutitive inhibition is necessary for drinking liquids which requires multiple rapid swallows (MRS). During MRS the esophageal body remains inhibited until the last of the series of swallows and then a peristaltic contraction wave follows. A normal response to MRS requires indemnity of both inhibitory and excitatory mechanisms and esophageal muscle. MRS has recently been used to assess deglutitive inhibition in patients with esophageal motor disorders. Examples with impairment of deglutitive inhibition are achalasia of the LES and diffuse esophageal spasm.
Brain Stem ; Contracts ; Deglutition ; Deglutition Disorders ; Drinking ; Esophageal Achalasia ; Esophageal Spasm, Diffuse ; Esophagus ; Humans ; Muscle, Skeletal ; Muscle, Smooth ; Muscles ; Swallows

To compare the safety, efficacy, predictability, stability and complications of wavefront-guided laser-assisted subepithelial keratectomy ( LASEK ) in low myopia, myopic astigmatism and high myopia correction.METHODS: A retrospective analysis of 416 eyes were assigned to 3 groups:159 eyes with low myopia ( LM) and mean refractive spherical equivalent (MRSE) of-3. 68±1. 33 dioptre ( D ); 161 eyes with myopic astigmatism ( MA ) and MRSE of -5. 99 ± 2. 24D and mean cylinder of 2. 41 ± 1. 07D;and 96 eyes with high myopia (HM) and MRSE of- 7. 41 ± 0. 80D. After an epithelial flap creation, a wavefront-based excimer laser ablation was performed. Safety, efficacy, predictability and stability were evaluated at day 10, 2, 6 and 12mo postoperatively.RESULTS:At 12mo, the MRSE was -0. 36 ± 0. 31D in LM group, 0. 15 ± 0. 41D in MA group and 0. 58 ± 0. 68D in HM group. The uncorrected visual acuity ( UCVA) was 20/20 in 90. 60% of patients in LM group, 78. 90% in MA group and 67% in HM group. Efficacy indices were 0. 98, 1. 04 and 0. 92 in LM, MA and HM groups, respectively. Safety indices were 1. 00, 1. 07 and 1. 05 in LM, MA and HM respectively. Five eyes (3. 1%) in the LM group gained 1 line. Forty-four eyes (27. 3%) in MA gained 1-3 lines and eighteen eyes (19. 2%) of HM group gained 1-2 lines of BSCVA. Only 2 eyes in LM group developed corneal haze. There were not statistically significant differences in efficacy and safety indices amongst three groups.CONCLUSlON:Wavefront-guided LASEK is an effective and safe procedure for the treatment of LM, MA, and HM. although in myopic astigmatism the predictability, efficacy and safety indices had been better.

Background/Aims: Extended wireless pH monitoring (WPM) is used to investigate gastroesophageal reflux disease (GERD) as subsequent or alternative investigation to 24-hour catheter-based studies. However, false negative catheter studies may occur in patients with intermittent reflux or due to catheter-induced discomfort or altered behavior. We aim to investigate the diagnostic yield of WPM after a negative 24-hour multichannel intraluminal impedance pH (MII-pH) monitoring study and to determine predictors of GERD on WPM given a negative MII-pH. Methods: Consecutive adult patients (> 18 years) who underwent WPM for further investigation of suspected GERD following a negative 24-hour MII-pH and upper endoscopy between January 2010 and December 2019 were retrospectively included. Clinical data, endoscopy, MII-pH, and WPM results were retrieved. Fisher’s exact test, Wilcoxon rank sum test, or Student’s t test were used to compare data.Logistic regression analysis was used to investigate predictors of positive WMP. Results: One hundred and eighty-one consecutive patients underwent WPM following a negative MII-pH study. On average and worst day analysis, 33.7% (61/181) and 34.2% (62/181) of the patients negative for GERD on MII-pH were given a diagnosis of GERD following WPM, respectively. On a stepwise multiple logistic regression analysis, the basal respiratory minimum pressure of the lower esophageal sphincter was a significant predictor of GERD with OR = 0.95 (0.90-1.00, P = 0.041). Conclusions WPM increases GERD diagnostic yield in patients with a negative MII-pH selected for further testing based on clinical suspicion. Further studies are needed to assess the role of WPM as a first line investigation in patients with GERD symptoms.