Ganglioglioma: comparison with other low-grade brain tumors

METHOD: Forty-two patients with low-grade brain tumor and refractory epilepsy were studied. The mean age was 22.3 years. They were divided into two groups: Group A, patients with ganglioglioma (n=19) and group B, patients with other low-grade tumors (n=23) (14 astrocytoma, 6 oligodendroglioma, 2 dysembryoplastic neuroepithelial tumor, and 1 xanthoastrocytoma). RESULTS: Age at seizure’s onset was 7 years or less in 73% of the patients in group A and in 30.4% of the patients in group B (p=0.045). Complex partial occurred frequently in group A and B (94.7% versus 82%, respectively). Seizure’s frequency was higher in group B (p=0.002).Computerized tomography (CT) was normal in 36.8% of group A patients and abnormal in all group B patients. Magnetic resonance imaging (MRI) was abnormal in all patients. Surgical removal was complete in 89.5% of the patients in group A and in 78.2% of the patients in group B. CONCLUSION: The association of refractory epilepsy and complex partial seizures, at a relatively low frequency, in young patients potentially normal CT and a MRI hypointense temporal lobe lesion in T1-weighed slices were habitual image findings in ganglioglioma, rather than other low-grade tumor.

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The effects of pulsed low frequency magnetic field in early rehabilitation of patients with cementless total hip arthroplasty

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0610414d ◽

2006 ◽

Vol 134 (9-10) ◽

pp. 414-419

Author(s):

Aleksandar Djurovic ◽

Mirjana Zivotic-Vanovic ◽

Dejan Popovic

Keyword(s):

Magnetic Field ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Low Frequency ◽

Early Rehabilitation ◽

Cementless Total Hip Arthroplasty ◽

Frequency Magnetic Field ◽

Group A ◽

High Doses ◽

Group B

Introduction: Early rehabilitation of patients with cementless total hip arthroplasty (cTHA) includes different physical modalities and pulsed low frequency magnetic field (PLFMF), which effects have not been explored yet. Objective: To investigate the effects of PLFMF which was applied in different doses in early rehabilitation of patients with cTHA. Method: Prospective, controlled, clinical study included 90 patients, divided in three groups with 30 patients each. First two groups were treated with high (group A) or low (group B) doses of PLFMF, in addition to kinesitherapy. Control group C was treated only with kinesitherapy. Study was completed in three weeks. Results: Subjects of group A had significantly lower pain than group B (p<0.01) and group C (p<0.001) subjects in the first postoperative week. Pain in group B subjects was significantly lower than in group C in all three postoperative weeks (p<0.01). In relation to other two groups, subjects of group A had higher hip Harris score values at the end of the third postoperative week (p<0.05), and they were faster on 10-meter distance at the end of the first postoperative week (p<0.01). Conclusion: PLFMF used in low and high doses for patients with cTHA had significant effects on pain abatement, especially at higher doses. Improvement of function was earlier and more manifested in the group treated with high doses of PLFMF.

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Keratoconus: early onset, the worst prognosis, eye rubbing and hand-dominance

Advances in Ophthalmology & Visual System ◽

10.15406/aovs.2020.10.00390 ◽

2020 ◽

Vol 10 (4) ◽

pp. 79-84

Author(s):

Anisur Rahman ◽

Sharah Rahman ◽

Jamsed Faridi ◽

Abdus Salam ◽

Tarzia Asma Zafrullah ◽

...

Keyword(s):

Observational Study ◽

Central Corneal Thickness ◽

Age Of Onset ◽

Corneal Thickness ◽

Young Patients ◽

Close Monitoring ◽

Dominant Hand ◽

K Value ◽

Group A ◽

Group B

Purpose: Keratoconus is an ectatic disorder of cornea and mostly involve teen aged group, still the pathogenesis and aetiology is not clearly defined. We try to establish the progression of the diseases is inversely proportional to the age of onset of the patient. Design: It was an observational study, carried out at a private eye hospital where patient was referred for RGP contact lenses. Methods: This observational study was carried out from Jan’ 2017 to Dec’ 2019 total three year period and 304 patients with Keratoconus were in the initial study and we divided them into two groups. Group: A, ≤25 years old and Group: B, >25 years old but among these 304 patient we included 200 patients in our study those who completed minimum 3 years follow-up and meet the inclusion criteria. Results: After three years ‘K’ value in group: A, <0.0001 in group: B, <0.3655. Sim K’s Astigmatism <0.0001 in group: A. <0.0223 in group: B. Central corneal thickness <0.0001 in group: A and 0.1957 in group: B. ‘K’ value and central corneal thickness (CCT) deteriorate more in group: A, than group: B. It is also found that KC progress more in case of VKC and it is more prominent in dominant hand side. Conclusion: At diagnosis, keratoconus is often more advanced in children than in adults, with faster disease progression. Early detection and close monitoring are therefore crucial in young patients.

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Surgical treatment of multiple brain metastases

Journal of Neurosurgery ◽

10.3171/jns.1993.79.2.0210 ◽

1993 ◽

Vol 79 (2) ◽

pp. 210-216 ◽

Cited By ~ 354

Author(s):

Rajesh K. Bindal ◽

Raymond Sawaya ◽

Milam E. Leavens ◽

J. Jack Lee

Keyword(s):

Brain Metastases ◽

Survival Time ◽

Prognostic Indicators ◽

Survival Duration ◽

Surgical Removal ◽

Complication Rates ◽

Multiple Brain Metastases ◽

Significant Difference ◽

Group A ◽

Group B

✓ The authors conducted a retrospective review of the charts of 56 patients who underwent resection for multiple brain metastases. Of these, 30 had one or more lesions left unresected (Group A) and 26 underwent resection of all lesions (Group B). Twenty-six other patients with a single metastasis who underwent resection (Group C) were selected to match Group B by type of primary tumor, time from first diagnosis of cancer to diagnosis of brain metastases, and presence or absence of systemic cancer at the time of surgery. Statistical analysis indicated that Groups A and B were also homogeneous for these prognostic indicators. Median survival duration was 6 months for Group A, 14 months for Group B, and 14 months for Group C. There was a statistically significant difference in survival time between Groups A and B (p = 0.003) and Groups A and C (p = 0.012) but not between Groups B and C (p > 0.5). Brain metastasis recurred in 31% of patients in Group B and in 35% of those in Group C; this difference was not significant (p > 0.5). Symptoms improved after surgery in 65% of patients in Group A, 83% in Group B, and 84% in Group C. Symptoms worsened in 13% of patients in Group A, 6% in Group B, and 0% in Group C. Groups A, B, and C had complication rates per craniotomy of 8%, 9%, and 8%, and 30-day mortality rates of 3%, 4%, and 0%, respectively. Guidelines for management of patients with multiple brain metastases are discussed. The authors conclude that surgical removal of all lesions in selected patients with multiple brain metastases results in significantly increased survival time and gives a prognosis similar to that of patients undergoing surgery for a single metastasis.

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Prognosis in young women less than 40 years of age with brain metastasis from breast cancer

Current Oncology ◽

10.3747/co.27.5621 ◽

2020 ◽

Vol 27 (1) ◽

Author(s):

A. Mustillo ◽

J. P. Ayoub ◽

D. Charpentier ◽

L. Yelle ◽

M. Florescu

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Brain Metastasis ◽

Young Women ◽

Young Patients ◽

Radiation Technology ◽

Group A ◽

Group B ◽

Initial Metastasis ◽

The Brain

Background Brain metastasis from breast cancer (bca) in young women is doubly devastating because both quality of life and life expectancy are significantly reduced. With new radiation technology and drugs that have emerged, survival is expected to increase for these young women.Methods Using the oacis and sardo patient databases, we identified 121 patients diagnosed with bca and brain metastasis between 2006 and 2016 at the University of Montreal Hospital Centre. Those patients were divided into Group A, patients who developed brain metastasis during the evolution of metastatic bca, and Group B, patients whose first metastasis was to the brain. For each group, we compared young patients (<40 years of age) with older patients (≥40 years of age).Results Among the 121 patients with brain metastasis, median overall survival (mos) was significantly longer for those less than 40 years of age than for those 40 or more years of age (18 months vs. 4 months, p < 0.001). With respect to the timing of brain metastasis, survival was significantly longer in Group B than in Group A (7 months vs. 4 months, p = 0.032). In Group A, mos was significantly longer for patients less than 40 years of age than for patients 40 or more years of age (18 months vs. 3 months, p = 0.0089). In Group B, the 2-year overall survival rate was 57% for patients less than 40 years of age and 12% for those 40 or more years of age (mos: not reached vs. 7 months; p = 0.259).Conclusions In our single-centre retrospective cohort of women with brain metastasis from bca, prognosis was better for young women (<40 years) than for older women (≥40 years). Survival was also longer for patients whose initial metastasis was to the brain than for patients whose brain metastasis developed later in the disease course. In patients who received systemic treatment, median survival remained significantly higher in women less than 40 years of age. Further studies are needed to validate those results.

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Ameliorating Effects of Transcutaneous Electrical Acustimulation at Neiguan (PC6) and Zusanli (ST36) Acupoints Combined with Adaptive Biofeedback Training on Functional Outlet Obstruction Constipation

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8798974 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Jie Liu ◽

Hulin Chen ◽

Dewei Wu ◽

Ruiling Wei ◽

Chaolan Lv ◽

...

Keyword(s):

Frequency Band ◽

Outlet Obstruction ◽

Low Frequency ◽

Biofeedback Training ◽

Before And After ◽

Balloon Expulsion ◽

Group A ◽

Functional Outlet Obstruction ◽

Group B ◽

Balloon Expulsion Test

Background. Stimulant laxatives are still considered the most common treatment for functional outlet obstruction constipation (FOOC). However, the effectiveness of laxatives is unsatisfactory, and the long-term use of laxatives may cause certain adverse events. With this in mind, it is, however, paramount that novel complementary treatment(s) and/or other forms of alternative medicine are adequately investigated. Aims. The study aims to explore the effects and potential mechanism(s) of transcutaneous electrical acustimulation (TEA) combined with adaptive biofeedback training (ABT) on FOOC. Methods. A total of forty-five patients with FOOC were recruited and were randomly assigned to receive either Macrogol 4000 Powder (MAC, 10 g bid) (group A, n = 15) only, ABT + MAC + Sham-TEA (group B, n = 15), or TEA + ABT + MAC (group C, n = 15) in a six-week study. Individual patients' constipation-symptoms (PAC-SYM) and constipation-quality of life (PAC-QOL) were both assessed and scored. Serum acetylcholine (Ach) and nitric oxide (NO) were measured from drawn blood samples while individual patients' heart rate variability (HRV) was calculated at baseline and after each corresponding therapy. Anorectal manometry and balloon expulsion test were both performed before and after treatment. Results. Firstly, participants in group C had significantly lower scores of PAC-SYM, PAC-QOL, and a decreased anal defecating pressure (ADP) as compared to participants in group B (all p<0.050). These results, however, suggest the TEAs effect. Secondly, the low-frequency band (LF)/(LF + HF) ratio in groups B and C were decreased as compared to group A (p=0.037, p=0.010, respectively) regarding HRV. On the other hand, the high-frequency band (HF)/(LF + HF) ratio in groups B and C showed an opposite outcome. Finally, the serum Ach in groups B and C was significantly higher as compared to group A (p=0.023, p=0.012, respectively). Of significant importance, the serum NO in groups B and C were notably low as compared to group A (p=0.001, p<0.001, respectively). Conclusions. TEA, combined with ABT, effectively improves constipation symptoms as well as QOL in FOOC patients. It is, however, achieved by decreasing ADP, which mechanisms are mediated via the autonomic and enteric mechanisms.

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Minimal Invasive Treatment for Defective Restorations: Five-Year Results Using Sealants

Operative Dentistry ◽

10.2341/12-062c ◽

2013 ◽

Vol 38 (2) ◽

pp. 125-133 ◽

Cited By ~ 26

Author(s):

J Martin ◽

E Fernandez ◽

J Estay ◽

VV Gordan ◽

IA Mjor ◽

...

Keyword(s):

Low Frequency ◽

Treated Group ◽

Recall Rate ◽

Marginal Adaptation ◽

Invasive Treatment ◽

Secondary Caries ◽

Fissure Sealant ◽

Significant Difference ◽

Group A ◽

Group B

SUMMARY Replacement of dental restorations has been the traditional treatment for restorations that are defective. In this five-year randomized clinical trial, restorations with localized marginal defects were treated with sealants. Thirty-two patients (mean age, 26.8 years) with 126 Class I and Class II restorations with defective margins (amalgam n=69 and resin-based composite n=57) were recruited. Treatment was seal with pit and fissure sealant on localized marginal defects (group A: n=43) and was compared with total restoration replacement (group B: n=40) and untreated restorations (group C: n=43) as negative and positive controls. Restorations were assessed by two examiners using the modified US Public Health Service criteria, observing five clinical parameters: marginal adaptation, roughness, marginal stain, teeth sensitivity, and secondary caries at baseline and at five years after treatment. At the five-year recall examination, 23 patients with 90 restorations (71.4% recall rate) were examined. A significant improvement was observed in the marginal adaptation of the restorations in group A compared with group B. None of the treated group showed trends to downgrade in any parameter. Tooth sensitivity and secondary caries showed a low frequency in all groups. No significant difference in marginal adaptation of the restorations was found between amalgam and resin-based composite restorations (p=0.191). This study demonstrated that marginal sealing of restorations is a minimally invasive treatment that may be used instead of the replacement of restorations with localized marginal defects.

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EFFICACY OF TENS WITH CONVENTIONAL OCCUPATIONAL THERAPY IN IMPROVING HAND FUNCTION OF STROKE SURVIVORS

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.8.1/006 ◽

2019 ◽

Vol 8 (1) ◽

pp. 25-30

Author(s):

Faiza Tahir ◽

Quratulain Khan

Keyword(s):

Occupational Therapy ◽

Conventional Therapy ◽

Controlled Trial ◽

Hand Function ◽

Low Frequency ◽

Optimal Recovery ◽

Stroke Survivors ◽

Stroke Patients ◽

Group A ◽

Group B

BACKGROUND AND AIM Stroke is currently the second leading cause of death and third main cause of disability throughout the world. Around 75% of stroke survivors suffered from upper limb dysfunction with limited functional activities whereas distal parts of upper extremity such as hand and forearm are mostly affected by stroke. Therefore, this study aims to determine the benefits of TENS along with conventional Occupational therapy in the rehabilitation of stroke patients to ascertain the optimal recovery of hand function. METHODOLOGY A Single-blind Randomized Controlled Trial was conducted on 76 individuals with acute phase or one-year history post-stroke. Group-A (n=38) received Low Frequency Transcutaneous Electrical Nerve Stimulation on elbow and wrist extensors (3 Hz, 400 μs)along with conventional Occupational therapy while Group-B (n=38) received conventional Occupational therapy only. Both the groups received intervention for 5 days/week of duration 45 minutes till 3 weeks. RESULTS Group-A showed significant improvement in means scores of FMA-UE and ARAT (p<0.05) in comparison to Group-B which showed moderate improvements in sensorimotor and activity capacity of hand function. CONCLUSION Conventional therapy along with TENS significantly improved the hand function in acute stroke patients as compared to the conventional therapy.

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Utilizing pre-operative MR imaging and adapting optimal needle puncture approach to improve radiofrequency ablation fraction of thoracic dorsal root ganglia

Scientific Reports ◽

10.1038/s41598-021-98050-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bing Li ◽

Yayong Huang ◽

Yong Zhang ◽

Sushant Kumar Das ◽

Chuan Zhang ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Thoracic Spine ◽

Dorsal Root ◽

Transforaminal Approach ◽

Mri Scans ◽

Group A ◽

Mri Sequences ◽

Magnetic Resonance Imaging Mri ◽

Group B ◽

Translaminar Approach

AbstractThis experimental study evaluates the location of thoracic dorsal root ganglions (DRGs) through magnetic resonance imaging (MRI) scans, and evaluates the radiofrequency ablation (RFA) fraction of different puncture approaches on distinct DRG locations. Eight normal adult corpse specimens were used as thoracic spine specimens. An MRI examination was performed on each specimen using the following MRI sequences: STIR T2WI, fs-FRFSE T2WI, and 3D FIESTA-c. Then thoracic spine specimens (n = 14) were divided into three groups for RFA: Group A, using a transforaminal approach irrespective of DRG location; Group B, using a transforaminal, trans-lateral-zygapophysial or translaminar approach according to the DRG location; and Group C using a combination of puncture approaches. The quality of visualization of thoracic DRGs on STIR T2WI, fs-FRFSE T2WI, and 3D FIESTA-c scans were 53.5% (77/144), 88.2% (127/144), and 93.1% (134/144), respectively. In group A, the RFA fractions of the extraforaminal DRGs (N = 29), intraforaminal DRGs (N = 12) and intraspinal DRGs (N = 7) via a transforaminal approach were 72.6 ± 18.9%, 54.2 ± 24.8% and 32.9 ± 28.1% respectively. In group B, RFA of extraforaminal DRGs via a transforaminal approach (N = 43) or a trans-lateral zygapophysial approach (N = 45) led to ablation fractions of 71.9 ± 15.2% and 72.0 ± 17.9%, respectively; RFA of intraforaminal DRGs via a transforaminal approach (N = 14) or a translaminar approach (N = 16) led to ablation fractions of 57.1 ± 18.0% and 52.5 ± 20.6%, respectively; RFA of intraspinal DRGs via a transforaminal approach (N = 12) or a translaminar approach (N = 14) led to ablation fractions of 34.8 ± 24.6% and 71.8 ± 16.0%, respectively. In group C, the combined approach led to an ablation fraction for extraforaminal DRGs (N = 69) of 82.5 ± 14.1%, for intraforaminal DRGs (N = 39) of 81.5 ± 11.8%, and for intraspinal DRGs (N = 36) of 80.8 ± 13.3%. MRI can accurately assess DRG location before RFA. Adopting different and combined puncturing approaches tailored to different DRG locations can significantly increase the DRG RFA fraction.

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USE OF FASCIA LATA & DACRON

The Professional Medical Journal ◽

10.29309/tpmj/2006.13.04.4936 ◽

2006 ◽

Vol 13 (04) ◽

Author(s):

MOHAMMUD AZIZ ◽

MOHAMMUD IQBAL KHATTAK

Keyword(s):

Range Of Motion ◽

Young Patients ◽

Elbow Dislocation ◽

Fascia Lata ◽

Civil Hospital ◽

Medical College ◽

Group A ◽

Group B

Setting: In Civil Hospital and Bolan Medical College Complex HospitalQuetta. Period: From 1990 to 2003. Materials & Method: Eighty cases of old neglected elbow dislocation weretreated. by arthroplasty using fascia lata (Group A) and dacron meshwork ( group B). Forty cases were included ineach group. Results: Surgery was followed by physiotherapy. Patients were examined periodically upto six months.To evaluate the results three variables i.e range of motion, instability and pain were recorded for each patient for sixmonths. These were recorded before operation, at the time of review and points were awarded. Young patients anddislocated elbows of less duration gave better results. Prognosis in males (As compared to females) and right elbows(As compared to left) was better. Group A achieved better results than group B. Conclusions: Results of both theinterposing materials are encouraging. Fascia lata gave better results than dacron meshwork

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A Retrospective Analysis of Psychiatric Presurgical Evaluation of Children and Adolescents Evaluated for Epilepsy Surgery in a Comprehensive Epilepsy Care Unit of Mumbai

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1742159 ◽

2022 ◽

Author(s):

Neena S. Sawant ◽

Suraj S. Singh ◽

Sachin Mahajan ◽

Sangeeta H. Ravat

Keyword(s):

Children And Adolescents ◽

Epilepsy Surgery ◽

Refractory Epilepsy ◽

Neurological Diseases ◽

Complex Partial Seizures ◽

International Classification Of Disease ◽

Oppositional Defiant ◽

Icd 10 ◽

Male Preponderance ◽

Magnetic Resonance Imaging Mri

Abstract Background Epilepsy being one of the most prevalent neurological diseases in children is associated with psychopathology and academic concerns. Epilepsy surgery is considered for refractory epilepsy at some centers in India and hence this study was undertaken to find out prevalence and type of psychopathology in children and adolescents with refractory epilepsy before epilepsy surgery. Methods All data were analyzed from the records of patients undergoing preepilepsy surgery protocol workup in comprehensive center of epilepsy care at a general municipal hospital in Mumbai. A record of 150 children and adolescents in the age group of 3 to 18 years over a period of 10 years was taken and all details of demographics, epilepsy, and psychopathology were recorded. Results The mean age for our sample was 11.4 ± 3.4 years and a male preponderance was seen. Majority (80%) of the children were pursuing education. The duration of seizure disorder was approximately 4.41 + 2.36 years and complex partial seizures were seen commonly in 50% of the children. Both magnetic resonance imaging (MRI) and video electroencephalography (VEEG) findings revealed right sided lateralization followed by left in majority of the patients. Psychopathology was seen in 70 (46%) patients with mental retardation, hyperkinetic disorders affecting attention and activity and oppositional defiant disorder, and unspecified mental disorder due to underlying brain damage being the type of International Classification of Disease-10th Revision (ICD-10) disorders seen. Patients with psychopathology showed a left-sided predominance on their MRI and VEEG findings for laterality of the epileptogenic focus as compared with right side. Conclusion Refractory seizures and associated psychopathology impact family life, friendships, and academics and worsen prognosis and quality of life. Screening for psychopathology in children with epilepsy would therefore lead to better outcomes especially prior to epilepsy surgery.

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