scholarly journals Functional outcome of instrumented and non-instrumented fusion in lumbar canal stenosis

2020 ◽  
Vol 6 (5) ◽  
pp. 981
Author(s):  
Ansari Muqtadeer Abdul Aziz ◽  
Nair Pradeepkumar Sasidharan ◽  
Ansari Ishtyaque Abdul Aziz ◽  
Venktesh Dattatray Sonkawade
Keyword(s):  
Functional Outcome ◽  
Indian Population ◽  
Graduate Training ◽  
Tertiary Care ◽  
Instrumented Fusion ◽  
Lumbar Canal Stenosis ◽  
Medical College ◽  
Canal Stenosis ◽  
Significant Difference ◽  
Post Graduate Training

<p><strong>Background:</strong> Lumbar canal stenosis (LSS) is a source of significant morbidity and economic burden in the Indian population. Spinal canal compression is the sine qua non of lumbar canal stenosis but whether instrumentation should be done or not is the major dilemma. In this study, we aim to compare the functional outcome of instrumented versus non-instrumented fusions for the treatment of lumbar stenosis along with the post-operative complications and cost-effectiveness of both procedures.</p><p><strong>Methods:</strong> This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between May 2016 and May 2018 were included. Patients were assessed using the modified Oswestry disability index (MODI) and visual analogue scale (VAS). These evaluations were done at 3, 6, 12 and 24 months.</p><p><strong>Results:</strong> We found similar pain relief and stabilization in both the groups in the initial post-operative period, but after 2 years, there was a significant difference (p=0.0001) between the two groups in terms of VAS (back) and MODI score. Complication rate was higher in instrumented patients. </p><p><strong>Conclusions:</strong> Patient selection is the most important thing in the management of lumbar canal stenosis. We believe that, with the flowchart on the management of lumbar canal stenosis, it would help choosing patients better as to who would require instrumented fusion. Non-instrumented fusions might cost less and have fewer complications, but the overall outcome of the patient in the future should be kept in mind.</p>

scholarly journals Results of posterior decompression with non-instrumented lumbar fusion surgery in cases of degenerative lumbar canal stenosis presenting with neurogenic claudication in a tertiary care hospital

2021 ◽  
Author(s):  
Maruti Bhujangrao Lingayat ◽  
Ansari Muqtadeer Abdul Aziz ◽  
Gaurav Balasaheb Mate ◽  
Sourabh Sahebrao Dhamale
Keyword(s):  
Lumbar Fusion ◽  
Tertiary Care ◽  
Long Term Results ◽  
Neurogenic Claudication ◽  
Care Hospital ◽  
Instrumented Fusion ◽  
Lumbar Canal Stenosis ◽  
Vas Score ◽  
Canal Stenosis ◽  
The Masses

<p><strong>Background:</strong> Degenerative lumbar canal stenosis remains an important public health problem in today’s date. With the overall average age of the world’s population rising steadily it is important to have an optimal treatment plan affordable to the masses. Non-instrumented fusion after decompression remains an important treatment option which is affordable to the masses and effectively treats the instability occurring due to degeneration process. This study aims to understand the results of such treatment in a tertiary care center catering to the masses.</p><p><strong>Methods: </strong>The study was conducted in 34 patients with diagnosed degenerative lumbar canal stenosis with neurogenic claudication who underwent decompressive laminectomy with a posterolateral strut graft posterolateral fusion from July 2018 to August 2020. Each patient was followed up for 12 months.</p><p><strong>Results: </strong>In the present study, a total of 34 patients with degenerative lumbar canal stenosis with neurogenic claudication were included. There were 18 male and 16 female patients. The pre-operative Swiss spinal stenosis Score was 61-80 (52.9%) and these scores improved to a majority of patients in the category of 21-40 (82.4%) at 1 year postoperatively. The average VAS score was 4.7±1.8 preoperatively while the average post op VAS score was 0.8±0.77.</p><p><strong>Conclusions: </strong>Non-instrumented fusion of the vertebrae with decompression has significantly improved results at 1 year follow up postoperatively and it is an excellent easy and cost-effective technique if used in a properly selected patient. Further studies are required to assess its long-term results.</p>

VAS score assessment for outcome of posterior lumbar inter body fusion in cases of lumbar canal stenosis

2016 ◽  
Vol 2 (3) ◽  
pp. 163
Author(s):  
Harish Murthy ◽  
T V S Reddy
Keyword(s):  
Back Pain ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Posterior Lumbar Interbody Fusion ◽  
Leg Pain ◽  
Lumbosacral Spine ◽  
Lumbar Canal Stenosis ◽  
Vas Score ◽  
Canal Stenosis ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> One of the major causes for disability in adult working population is degenerative lumbosacral spine disorders are fairly common in middle aged and elderly population. Lumbar canal stenosis remains one of the most frequently encountered clinically important degenerative spinal disorders requiring operative treatment in the aging population. The objective of the present study is to assess the outcome of posterior lumbar inter body fusion in cases of lumbar canal stenosis</p><p class="abstract"><strong>Methods:</strong> The present study, 30 cases of lumbar canal stenosis, who were treated operatively with decompression and posterior lumbar inter body fusion, which was carried out over a period of 6 months in a tertiary care center were included. 16 women and 14 men were included in the study.<strong></strong></p><p><strong>Results:</strong> Most patients were in the age group of 41-50 years (36.7%) followed by 51-60 years (33.3%). In this study it was found that there was significant improvement in VAS score for back pain and leg pain over the 6 month follow-up. There is significant difference between mean improvement in VAS score with respect to number of levels involved for leg pain (p =0.01).  There is no statistical significance difference between number of levels involved and improvement in back pain (p =0.66).</p><strong>Conclusions:</strong>VAS score showed posterior lumbar interbody fusion with interbody cage and local graft with posterior instrumentation gave significantly improved clinical and functional outcome by causing significant reduction in pain and patient disability.<p> </p>

scholarly journals Serum Zinc Status in Post Menopausal Women Attending in a Tertiary Care Hospital of Bangladesh

2019 ◽  
Vol 9 (2) ◽  
pp. 147-150
Author(s):  
Nadia Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Fahmida Islam ◽  
Shabnam Sarwar Sejooti
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Serum Zinc ◽  
Premenopausal Women ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Zinc Levels ◽  
Serum Zinc Levels

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology , Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal womenaged between 45-70 years were considered as case and another 50 regular menstruating premenopausal women aged between 30-40 years were selected as control. Results: The mean age of case and control groups was 50.5± 2.3 years and 36.5± 4.4 years respectively. In this study serum zinc levels in cases and controls were 71.54 ± 5.69 ìg /dl and 74.68 ± 5.453 ìg/dl respectively, and there was significant difference(p<0.01). Conclusion: Serum zinc level was significantly decreased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum zinc levels might be incorporated in every postmenopausal for possible prevention of complications. Birdem Med J 2019; 9(2): 147-150

scholarly journals Estimation of Serum Copper in Post-menopausal Women Attending in a Tertiary Care Hospital, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
N Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Syed Md Tanjilul Haque ◽  
ANM Ashikur Rahman Khan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Serum Copper ◽  
Copper Level ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal women (Case) aged between 45-60 years were considered as case and another 50 regular menstruating premenopausal women(Control) aged between 30-40 years were selected as control. Results: The mean age of cases and control groups was 50.5±2.3 years and 36.5±4.4 years respectively. In this study we found Serum Copper levels in cases and controls were 115.36±8.836 µg /dl and 90.58 ±6.315 µg/dl respectively had (p< 0.01) significant difference. Conclusion: Serum Copper level was significantly increased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum Cu level might be incorporated in every postmenopausal woman for prevention of complications. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 110-113

scholarly journals Focused Versus Conventional Radiotherapy in Spinal Oncology: Is There any Difference in Fusion Rates and Pseudoarthrosis?

2021 ◽  
Author(s):  
Oluwaseun Akinduro ◽  
Geatano DeBiase ◽  
Anshit Goyal ◽  
Jenna H Meyer ◽  
Roman O Kowalchuk ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Spinal Tumors ◽  
Wound Complications ◽  
Tumor Type ◽  
Conventional Radiotherapy ◽  
Instrumented Fusion ◽  
Radiation Delivery ◽  
Increased Risk ◽  
Significant Difference ◽  
Secondary Outcomes

Abstract IntroductionRadiotherapy is considered standard of care for adjuvant peri-operative treatment of many spinal tumors, including those with instrumented fusion. Unfortunately, radiation treatment has been linked to increased risk of pseudoarthrosis. Newerfocused radiotherapy strategies with enhanced conformalitycould offer improved fusion rates for these patients, but this has not been confirmed.MethodsWe performed a retrospective analysis of patients at three tertiary care academic institutions withprimary and secondary spinal malignancies that underwent resection, instrumented fusion, and peri-operative radiotherapy. Two board certified neuro-radiologists used theLenke fusion score to grade fusion status at6 and 12-months after surgery. Secondary outcomes includedclinical pseudoarthrosis, wound complications, and the effect of radiation timing, radiobiological dose delivered, the use of photons versus protons, tumor type, tumor location,and use of autograft on fusion outcomes.ResultsAfter reviewof 1252 spinal tumor patients, there were 60 patients with at least 6 months follow-up that were included in our analyses. Twenty-five of these patients received focused radiotherapy,20 patients received conventional radiotherapy, and 15 patients were treated with protons. There was no significant difference between the groups for covariates such assmoking status,obesity, diabetes, intraoperative use of autograft, and use of peri-operative chemotherapy. There was a significantly higher rate of fusion for patients treated with focused radiotherapy compared to those treated with conventional radiotherapy at 6-months (64.0% versus 30.0%, Odds ratio: 4.15, p=0.036) and 12-months (80.0% versus 42.1%, OR: 5.50, p=0.022). There was a significantly higher rate of clinical pseudoarthrosis in the conventional radiotherapy cohortcompared to patients in the focused radiotherapy cohort (19.1% versus 0%,p=0.037). There was no difference in fusion outcomes for any of the secondary outcomes except for use of autograft. The use ofintra-operative autograft was associated with an improved fusion at 12-months (66.7% versus 37.5%, OR: 3.33, p=0.043). ConclusionFocused radiotherapy may be associated withan improved rate of fusion and clinical pseudoarthrosis when compared to conventional radiation delivery strategiesin patients with spinal tumors.Use of autograft at the time of surgery may be associated with improved 12-month fusion rates.Further large-scale prospective and randomized controlled studies are needed to better stratify the effects of radiation delivery modality in these patients.

scholarly journals An Anthropometric Comparison of Inner Canthal Distance, Outer Canthal Distance and Canthal Index in the Indian and Nepalese Undergraduate Students of Nepalgunj Medical College

2018 ◽  
Vol 14 (2) ◽  
pp. 12-14
Author(s):  
N Adhikari ◽  
M N Ambekar ◽  
S KC
Keyword(s):  
Undergraduate Students ◽  
Indian Population ◽  
Age Group ◽  
Same Sex ◽  
Female Undergraduate ◽  
Male Population ◽  
Facial Aesthetics ◽  
Medical College ◽  
Significant Difference ◽  
Indian Male

 Background: The canthal distances are one of the most important aspects in ascessing the facial aesthetics. Several authors have described changes in the canthal distances attributable to race and gender.Aims and Objectives: To compare the inner canntahl distance, outer canthal distance and canthal index in between Nepalese and Indian undergraduate students of Nepalgunj Medical College.Materials and Methods: The study was conducted to compare canthal distances and canthal index among 320 (160 Indians: 100 male,60 female and 160 Nepalese: 100 male and 60 female) undergraduate students of Nepalgunj Medical College of age group 18-24 years at Department of Anatomy, Chisapani, Banke. Inner canthal distance(ICD) and Outer canthal Distance(OCD) were measured by using round end spreading caliper and Canthal Index were calculated by ICD/OCD *100. The value obtained was compared among Indian and Nepalese students in both sexes by using student t-test.Result: The study showed that there was no any significant difference on the value of inner and outer canthal distances and canthal index observed between Nepalese and Indian population except on the value of canthal index which was significantly different between Indian male and Nepalese male population. However, when the comparison was done between the sexes, inner and outer canthal distances and canthal index of males are larger than females except on the value of canthal index of Indian males and Indian females which was non-significant.Conclusion: There occurred a sexual dimorphism within Indian and Nepalese population except on canthal index of Indian male and Indian female but there wasn't any significant differences between Nepalese and Indian population of same sex except on canthal index of Indian male and Nepalese male. JNGMC,  Vol. 14 No. 2 December 2016, Page: 12-14

scholarly journals Comparative Study of Length and Diameter of Umbilical Cord in Normal Vs Gestational Hypertensive cases in a Tertiary Care Hospital in Eastern Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 68-71
Author(s):  
Abhishek Karn ◽  
Subodh Kumar Yadav ◽  
Renu Yadav ◽  
Rakesh Kumar Adhikari
Keyword(s):  
Umbilical Cord ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Medical College ◽  
Number Of Factors ◽  
Significant Difference ◽  
The Difference ◽  
Umbilical Cords

INTRODUCTION :- The well being of the fetus and hence the baby is influenced by a number of factors among which the length and diameter of umbilical cord is one important aspect. Studies have found association between gestational hypertension and the structure of umbilical cord. The objective of this study was to determine the effects of gestational hypertension on the length and diameter of umbilical cord.  MATERIAL AND METHODS :- A total of 70 umbilical cords with placenta were collected in Nobel Medical College and Teaching Hospital for comparison of umbilical cords length and diameter between normotensives and patients with gestational hypertension. Data were statistically analyzed.  RESULTS :- The difference in umbilical cords' diameter was statistically significant between normotensives and patients with gestational hypertension whereas the length of the umbilical cord had no statistically significant difference.  CONCLUSION :- We concluded that gestational hypertension affects the diameter of umbilical cord by decreasing it significantly which may affect normal fetal development.

scholarly journals Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Treatment Pattern ◽  
Operative Procedures ◽  
Care Hospital ◽  
Third Generation ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

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