Search PubMed⌕ Search

Biomedical subjects

Z Awad

Publications and source records attributed to Z Awad.

8 recordsLinked to original sources
PubMed2006

Management of surgical airway emergencies by junior ENT staff: a telephone survey.

OBJECTIVE: To determine levels of confidence in the management of surgical airway emergencies by junior ENT staff. DESIGN: Telephone survey. PARTICIPANTS: 100 Senior House Officers (SHOs) from 100 hospitals in the UK, providing 24 hour first on-call emergency ENT cover. METHOD: A list of questions was put to participants. The effects of different variables on confidence with airway emergencies and what SHOs considered to be adequate training were compared. RESULTS: Most SHOs provided cover for the management of surgical airway emergencies. Many of the participants were not confident to handle airway emergencies or felt that their training was inadequate. As expected, the amount of previous experience in ENT and the ability to perform advanced airway procedures gave SHOs greater confidence, but attendance at airway courses did not. CONCLUSION: Confidence in the management of airway problems is variable and does not correlate well with perceived adequacy of training. We suggest that systems of training in airway management are improved. Training issues may be better approached at an individual level, where deficiencies can be addressed.

Airway Obstruction↗
PubMed2006

Sub-diaphragmatic fascia: role in the recurrence of hiatal hernias.

One of the most common causes of a failed Nissen fundoplication is disruption of the crural repair. We investigated the thickness of the subdiaphragmatic fascia overlying the right and left limb of the right crus in cadavers to determine any difference. Sub-diaphragmatic fascia specimens were obtained from three sites adjacent to the hiatus in 20 preserved cadavers. One square centimeter of fascia was excised 3 cm from the arch of the hiatus on each side and approximately 2-3 mm from the edge of the hiatal opening (labeled RL and LPL). A third sample was taken 1 cm from the arch of the hiatus on the left side (labeled LAL). The thickness of these tissues was measured. The mean tissue thickness of RL, LPL and LAL were 0.22 mm, 0.23 mm and 0.4 mm, respectively. There was no difference in tissue thickness between the lower specimens on both sides (RL vs. LPL); however, LAL was significantly thicker than both RL and LPL (P < 0.05). The thickness of the subdiaphragmatic fascia overlying the right and left limb of the right crus does not differ significantly in the region used for crus closure during antireflux surgery; however, the fascia on the left is thicker anteriorly.

Cadaver↗
PubMed2006

A randomized controlled trial: is water better than a standard lubricant in nasendoscopy?

OBJECTIVES: Previous studies have shown that nasendoscopy is made easier with the use of lubrication at the expense of the quality of the view obtained, but had no effect on the discomfort or pain experienced by the patient. We set out to determine whether the advantages of lubrication with a standard lubricant (KY Jelly) could be achieved by using water, without incurring the same disadvantages. DESIGN: Single blind randomized controlled trial. SETTING: Outpatient Departments at two District General Hospitals. PARTICIPANTS: One hundred and fifty participants selected sequentially from patients requiring a nasendoscopy where the endoscope would be passed far enough to view the larynx. Patients requiring topical anaesthetic were excluded. METHODS: Patients were randomly assigned to have either water or standard lubricant applied to the nasendosope prior to nasendoscopy. Levels of pain experienced by the patient were recorded on a visual analogue score as well as visual analogue scores from the clinician for the levels of difficulty in passing the endoscope. All participants who were entered the study completed the study. Endoscopy was performed by all grades of medical staff. MAIN OUTCOME MEASURES: Levels of pain experienced by the participants were assessed by a visual analogue scale. Difficulty of passing the scope was indicated by the endoscopist using a visual analogue scale, as was the quality of image obtained. RESULTS: Endoscopists found the insertion of the endoscope was easier and the image better when water was used rather than KY Jelly. There was no significant difference in reported in levels of pain experienced by the patient. CONCLUSION: Although the use of water as a lubricant during nasendoscopy confers no additional benefit in term of the levels of pain suffered by patients during the procedure, it makes the insertion of the endoscope easier and provides a better quality image than standard lubrication.

Adult↗
PubMed2006

How we do it: analysing GP referral priorities: the unforeseen effect of 'Choose and Book'.

The introduction of Choose and Book may have a significant effect on the proportion of urgent referrals seen by ENT surgeons. Much of the responsibility for prioritisation will be transferred to the GP. Patients who are considered urgent by the ENT surgeon will be added to those considered urgent by the GP. Our results show that there was little agreement between GPs and ENT surgeon on what constitutes an urgent referral. The combined effect of joint prioritisation and the removal of the 'soon' category resulted in a 270% increase in 'urgent' referrals in our sample. This potentially unforeseen consequence of the Choose and Book system should be taken into consideration by ENT departments to allow for an expansion of the 'urgent' category.

Appointments and Schedules↗
PubMed2005

The use of lubrication in flexible fibreoptic nasendoscopy: a randomized controlled trial.

OBJECTIVES: To determine how lubrication of the endoscope prior to flexible fibreoptic nasendoscopy affects levels of patient discomfort and pain during endoscopy. To assess the extent to which lubrication affects the ease of nasendoscopy and the quality of the image obtained. DESIGN: Single blind, randomized controlled trial. SETTING: Outpatient clinic of the Department of Otolaryngology at a secondary level referral centre. PARTICIPANTS: A total of 150 participants selected sequentially from patients requiring a nasendoscopy where the endoscope would be passed far enough to view the larynx. Patients requiring topical anaesthetic were excluded. All participants who were entered in the study completed the study. Endoscopy was performed by all grades of medical staff. MAIN OUTCOMES MEASURES: Levels of discomfort and pain experienced by the participants were assessed by a visual analogue scale (VAS). Difficulty of passing the scope was indicated by the endoscopist using a VAS, as was the quality of image obtained. RESULTS: There was no significant difference between mean scores for pain or discomfort of the lubricated and unlubricated groups (P = 0.46 and P = 0.82 respectively). Scores for difficulty of passing the scope were significantly lower in the lubricant group (P = 0.003) but loss of image was significantly greater (P = 0.008). CONCLUSIONS: Lubrication of the endoscope prior to nasendoscopy does not reduce levels of discomfort or pain for the patient, but increases ease in insertion for the operator. However, this may be at the expense of reduced image quality.

Adult↗
PubMed1998

Transient otoacoustic emissions in children with chronic renal failure.

This study was conducted on 34 children with chronic renal failure: 27 on regular haemodialysis and seven on conservative treatment. Twenty normal healthy children served as controls. They were subjected to clinical examination including otoscopic examination, basic audiological assessment and transient otoacoustic emission testing (TOAE). Four patients had a conductive hearing loss and five had a bilateral moderately severe high frequency sensory neural hearing loss. TOAE testing was carried out for the rest whose ears displayed normal hearing. No response (fail) was obtained in 8% of them but in none of the controls and a partial pass response in 38% versus 10% of controls (P < 0.001). Cochlear dysfunction was significant only at low frequency levels. The mean overall echo-level and reproducibility were significantly lower in patients than in controls. The same holds true for the subgroup of patients on haemodialysis but not for those on conservative treatment. The overall echo-levels did not correlate with serum urea, creatinine, sodium or potassium.

Acoustic Impedance Tests↗