The Experts below are selected from a list of 516 Experts worldwide ranked by ideXlab platform
Ramandeep Singh - One of the best experts on this subject based on the ideXlab platform.
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intractable glaucoma following intravitreal Triamcinolone in central retinal vein occlusion
American Journal of Ophthalmology, 2004Co-Authors: Sushmita Kaushik, Vishali Gupta, Amod Gupta, Mangat R Dogra, Ramandeep SinghAbstract:PURPOSE: To document secondary glaucoma observed after intravitreal injection of Triamcinolone for cystoid macular edema in central retinal vein occlusion. DESIGN: An interventional case series. METHODS: Retrospective study. The setting was a tertiary care referral institute. Nine patients with central retinal vein occlusion and cystoid macular edema received 4.0 mg/0.1 ml of intravitreal Triamcinolone Acetate injected through the inferior pars plana under topical anesthesia. Baseline intraocular pressures were normal in all, and no patients had glaucoma. RESULTS: Seven of the nine patients had a post-injection rise in intraocular pressures, of which one had intractable secondary glaucoma requiring removal of the depot corticosteroid by pars plana vitrectomy combined with trabeculectomy. Two patients were controlled only by maximal medical therapy. CONCLUSIONS: The occurrence of intractable glaucoma after intravitreal Triamcinolone in central retinal vein occlusion is a serious concern and warrants caution in the use of this modality for these patients.
Alessandro Rossi - One of the best experts on this subject based on the ideXlab platform.
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Effects of Local Corticosteroid Injection on Electrical Properties of Aβ-Fibers in Carpal Tunnel Syndrome
Journal of Molecular Neuroscience, 2014Co-Authors: Federica Ginanneschi, Giorgios Filippou, Marco Bonifazi, Bruno Frediani, Alessandro RossiAbstract:Very few data are available on the structural and functional effects of corticosteroids on peripheral nerve fibers. This paper is addressed to verify possible changes in the functional properties of myelinated Aβ fibers of the median nerve in carpal tunnel syndrome (CTS) after a local injection of Triamcinolone Acetate. Thirteen subjects affected by mild CTS and 13 controls were selected. Clinical, electrophysiological, and ultrasonographic (cross sectional area: CSA) data of the median nerve were quantified at 0 (pre-injection), and 1 month after Triamcinolone injection at wrist. We analyzed the input–output curves constructed by plotting the response amplitude as a function of stimulus intensity. After corticosteroid injection, all patients experienced symptom relief, the median nerve CSA decreased, and the plateau value of the input–output curve was significant higher than before the treatment. Pre injection, we observed a significant inverse correlation between median nerve CSA and plateau value of the input–output curve, which remained significant even after the corticosteroid injection. The Aβ fibers with higher electrical threshold undergo conduction recovery after local corticosteroid injection. In CTS, combined mechanisms might contribute to resolution of symptoms: anti-edema/anti-inflammatory action and direct effect on the electrical properties of the nerve fibers.
Raj Mitra - One of the best experts on this subject based on the ideXlab platform.
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Efficacy of Fluoroscopically Guided Steroid Injections in the Management of Coccydynia
November 2007, 2007Co-Authors: Raj MitraAbstract:Background: Coccydynia is a rare but painful disorder characterized by axial coccygeal pain which is typically exacerbated by pressure. Management includes physical therapy/rectal manipulation, use of anti-inflammatory medications, modality use, coccygectomy, and fluoroscopically guided steroid injections. There are no studies documenting the efficacy of fluoroscopically guided coccygeal steroid injections in patients with coccydynia. Methods: Retrospective chart review was used to collect data on 14 consecutive patients diagnosed with coccydynia who underwent a fluoroscopically guided coccygeal injection of 80 mg Triamcinolone Acetate and 2mg of 1% lidocaine over a 3-year period at a tertiary care academic medical center. Results: Using stepwise logistic regression, acute pain was determined to be the best predictor of relief. Fisher’s exact test showed that those patients with pain lasting less then 6 months were significantly more likely to have greater than 50% relief (P=0.055). Patients with chronic pain longer than 6 months were not found to have pain relief of >50% to any statistical significance, but every patient with acute pain showed improvement. Conclusion: Patients with acute pain (less then 6 months) are more likely to respond to fluoroscopically guided coccygeal steroid injections. Key words: Coccydynia, steroid injection, fluroscopy.
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interspinous ligament steroid injections for the management of baastrup s disease a case report
Archives of Physical Medicine and Rehabilitation, 2007Co-Authors: Raj Mitra, Usama H Ghazi, Dhiruj Kirpalani, Ivan ChengAbstract:Mitra R, Ghazi U, Kirpalani D, Cheng I. Interspinous ligament steroid injections for the management of Baastrup's disease: a case report. Baastrup's disease has been identified as a source of axial low back pain. There has been debate as to the etiology of pain in patients with Baastrup's disease. It has been theorized that the pain may originate from degenerative disk disease and spinal stenosis associated with the disease, whereas some have identified the neoarthrosis between joints and accompanying reactive eburnation as the source of pain. We present a simple case report of an 89-year-old woman with symptomatic Baastrup's disease. The patient underwent a fluoroscopically guided interspinous process injection of 20mg of Triamcinolone Acetate with local anesthetic. The patient remained pain free for 3 months. The neoarthrosis in Baastrup's disease may be the primary pain generator in cases of Baastrup's disease without significant central canal stenosis.
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Efficacy of fluoroscopically guided steroid injections in the management of coccydynia.
Pain physician, 2007Co-Authors: Raj Mitra, Lance Cheung, Patrick PerryAbstract:BACKGROUND Coccydynia is a rare but painful disorder characterized by axial coccygeal pain which is typically exacerbated by pressure. Management includes physical therapy/rectal manipulation, use of anti-inflammatory medications, modality use, coccygectomy, and fluoroscopically guided steroid injections. There are no studies documenting the efficacy of fluoroscopically guided coccygeal steroid injections in patients with coccydynia. METHODS Retrospective chart review was used to collect data on 14 consecutive patients diagnosed with coccydynia who underwent a fluoroscopically guided coccygeal injection of 80 mg Triamcinolone Acetate and 2mg of 1% lidocaine over a 3-year period at a tertiary care academic medical center. RESULTS Using stepwise logistic regression, acute pain was determined to be the best predictor of relief. Fisher's exact test showed that those patients with pain lasting less then 6 months were significantly more likely to have greater than 50% relief (P=0.055). Patients with chronic pain longer than 6 months were not found to have pain relief of >50% to any statistical significance, but every patient with acute pain showed improvement. CONCLUSION Patients with acute pain (less then 6 months) are more likely to respond to fluoroscopically guided coccygeal steroid injections.
Rajan Madhok - One of the best experts on this subject based on the ideXlab platform.
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A case of shingles mimicking carpal tunnel syndrome
Annals of the rheumatic diseases, 2001Co-Authors: Hilary D. Wilson, Jennifer Hamilton, Rajan MadhokAbstract:A 59 year old woman with an eight year history of seropositive erosive rheumatoid arthritis (RA) receiving sulfasalazine and penicillamine presented with severe sudden onset pain radiating from the left elbow to the left thumb, index and middle fingers. Examination disclosed synovitis of the left wrist, which might have caused median nerve compression. The wrist joint was injected with 20 mg of Triamcinolone Acetate with 1% lidocaine (lignocaine). She returned the …
Daniel Briscoe - One of the best experts on this subject based on the ideXlab platform.
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Fornix Triamcinolone injection for thyroid orbitopathy
Graefe's Archive for Clinical and Experimental Ophthalmology, 2015Co-Authors: Shirin Hamed-azzam, Abed Mukari, Ilan Feldman, Walid Saliba, Haneen Jabaly-habib, Daniel BriscoeAbstract:Purpose In this pilot study we aimed to examine the association between eyelid fornices Triamcinolone injections and clinical activity score in patients with active thyroid orbitopathy. Methods Adult patients aged 18 years or older, diagnosed with active thyroid orbitopathy and a clinical activity score ≥3 were recruited to this interventional prospective pilot study between 2010 and 2013. Three upper and lower fornices injections of Triamcinolone Acetate 20 mg (40 mg/ml) were administered at 4-week intervals. Each patient included was followed up for a period of 6 months. Clinical activity score was estimated at each monthly visit. Extraocular muscle thickness was measured by ultrasound examination at entrance and at the last visit. Results Eleven eyes of seven patients were included in our study. Initial clinical activity score was 3.81 ± 1.80 and fell to 0.63 ± 0.72 during a 6-month follow-up. There was a significant difference in clinical activity score between the baseline examination and the following visits ( p -value
