Functional Outcome of Neurotization to The Musculocutaneous Nerve in Traumatic Brachial Plexus Injury

Introduction: Neurotization procedures to the elbow flexors are commonly done in traumatic brachial plexus injury (BPI). The objective of this study was to evaluate the recovery of elbow flexors in patients who underwent neurotization procedure to musculocutaneous nerve in the panplexus and upper trunk BPI. Materials and Methods: This was a cross sectional study involving 70 patients who underwent neurotization to elbow flexor. A total of 31 patients (44%) had panplexus injury and 39 (56%) had upper trunk BPI. Elbow flexor motor power and post-operative Disabilities of the Arm, Shoulder and Hand (DASH) score were evaluated. Results: The mean age of the patients was 22.7 years. Patients with panplexus BPI underwent neurotization to the elbow flexor using spinal accessory nerve as a donor and patients with upper trunk BPI used either ulnar or median nerve as a donor. The results of elbow flexors recovery in panplexus BPI were good (MRC grade 4 and 5) in 11 patients (35.5%) and poor in 20 patients (64.5%). Conversely, the recovery of elbow flexors in upper trunk BPI were better with 28 patients (71.8%). Good post-operative DASH score (score <50 points) were noted in 29 patients (74.4%) with upper trunk BPI. Only seven patients (22.6%) with panplexus BPI showed good post-operative DASH score. Majority of patients with panplexus BPI demonstrated poor recovery of elbow flexor and post-operative DASH score as compare to upper trunk BPI (p= 0.002). Conclusion: Overall, this study showed significantly better functional outcome of neurotization procedure to elbow flexor in upper trunk BPI than in panplexus BPI.

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Social support, functional outcome and quality of life among stroke survivors in an urban area

Journal of Pacific Rim Psychology ◽

10.1017/prp.2019.2 ◽

2019 ◽

Vol 13 ◽

Author(s):

Nipaporn Butsing ◽

Mathuros Tipayamongkholgul ◽

Disya Ratanakorn ◽

Nawarat Suwannapong ◽

Kanitta Bundhamcharoen

Keyword(s):

Quality Of Life ◽

Social Support ◽

Functional Outcome ◽

Short Form ◽

Cross Sectional Study ◽

Linear Regression Method ◽

Stroke Survivors ◽

Cross Sectional ◽

The Mean

AbstractSophisticated medical technologies can prolong a stroke patient’s life but not always their quality of life (QoL) due to poor functional outcomes. Social support can theoretically assist a patient’s adaptation to life after stroke and improve their QoL, but existing findings are inconclusive. This inconclusiveness is especially found in large cities where family and social bonding can be scarce. We conducted a hospital-based, cross-sectional study among 358 stroke patients to identify the effects of social support and functional outcome on QoL and its domains. The study took place in Bangkok, Thailand between July and December 2016. Data were collected by personal interview using a structured questionnaire that included the Short-Form WHO Quality of Life Instrument (WHOQOL-BREF) and by review of medical records. A hierarchical linear regression method was used to analyze data. The mean age of stroke respondents was 66.0 years (SD 13.5 years), and half were male. The mean total QoL score for patients was 68.6 (SD 15.2). Hierarchical multiple regression analysis found emotional support significantly impacted QoL in every domain (ps < .05) when all included variables were controlled for. To improve the quality of life among stroke survivors, health personnel and family members should provide not only physical assistance but also psychological support.

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Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

Annals of Surgical Oncology ◽

10.1245/s10434-021-09774-6 ◽

2021 ◽

Author(s):

Gilber Kask ◽

Jussi P. Repo ◽

Erkki J. Tukiainen ◽

Carl Blomqvist ◽

Ian Barner-Rasmussen

Keyword(s):

Quality Of Life ◽

Soft Tissue ◽

Lower Extremity ◽

Functional Outcome ◽

Cross Sectional Study ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

The Mean

Abstract Background Few studies have focused on patient-related factors in analyzing long-term functional outcome and health-related quality of life (HRQoL) in patients with postoperative lower extremity soft tissue sarcoma (STS). Objective The purpose of this study was to investigate factors associated with postoperative functional outcome and HRQoL in patients with lower extremity STS. Methods This cross-sectional study was performed in a tertiary referral center using the Toronto Extremity Salvage Score (TESS), Quality-of-Life Questionnaire (QLQ)-C30 and 15 Dimension (15D) measures. Functional outcome and HRQoL data were collected prospectively. All patients were treated by a multidisciplinary team according to a written treatment protocol. Results A total of 141 patients who had undergone limb-salvage surgery were included. Depending on the outcome measure used, 19–51% of patients were completely asymptomatic and 13–14% of patients had an unimpaired HRQoL. The mean score for TESS, 15D mobility score, and QLQ-C30 Physical Functioning scale were 86, 0.83, and 75, respectively, while the mean score for 15D was 0.88, and 73 for QLQ-C30 QoL. Lower functional outcome was statistically significantly associated with higher age, higher body mass index (BMI), and the need for reconstructive surgery and radiotherapy, while lower HRQoL was statistically significantly associated with higher age, higher BMI, and reconstructive surgery. Conclusion Functional outcome and HRQoL were generally high in this cross-sectional study of patients with STS in the lower extremity. Both tumor- and treatment-related factors had an impact but patient-related factors such as age and BMI were the major determinants of both functional outcome and HRQoL.

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High prevalence of neuropathic pain in the hand of patients with traumatic brachial plexus injury: a cross-sectional study

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160149 ◽

2016 ◽

Vol 74 (11) ◽

pp. 895-901 ◽

Cited By ~ 9

Author(s):

Marcus V. B. Santana ◽

Mauro T. Bina ◽

Matheus G. Paz ◽

Scheila N. Santos ◽

Manoel J. Teixeira ◽

...

Keyword(s):

Quality Of Life ◽

Neuropathic Pain ◽

Brachial Plexus ◽

Brachial Plexus Injury ◽

Young Male ◽

Cross Sectional Study ◽

Male Victims ◽

Cross Sectional ◽

Motorcycle Accidents

ABSTRACT Objective To describe the pain profile of patients with traumatic brachial plexus injury. Methods We enrolled 65 patients with traumatic brachial plexus injury. The Douleur Neuropathique 4 questionnaire was used to classify pain and the SF-36 was used to evaluate quality of life. Results The patients with traumatic brachial plexus injury were predominantly young male victims of motorcycle accidents. Pain was present in 75.4% of the individuals and 79% presented with neuropathic pain, mostly located in the hands (30.41%). The use of auxiliary devices (p = 0.05) and marital status (p = 0.03) were both independent predictors of pain. Pain also impacted negatively on the quality of life (p = 0.001). Conclusions Pain is frequent in patients with traumatic brachial plexus injury. Despite the peripheral nervous system injury, nociceptive pain is not unusual. Pain evaluation, including validated instruments, is essential to guide optimal clinical management of patients with the condition.

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Association between HbA1c and functional outcome of new onset ischemic stroke in Diabetic patients

Journal of Dhaka Medical College ◽

10.3329/jdmc.v27i1.38886 ◽

2018 ◽

Vol 27 (1) ◽

pp. 5-8

Author(s):

Hashmi Sina ◽

AKM Anwar Ullah ◽

Subash Kanti Dey ◽

Md Amir Hossain ◽

Sharif Uddin Ahmed ◽

...

Keyword(s):

Ischemic Stroke ◽

Functional Outcome ◽

Cross Sectional Study ◽

Current Smoker ◽

Diabetic Patients ◽

Cross Sectional ◽

Female Ratio ◽

Abnormal Glucose Metabolism ◽

The Mean ◽

New Onset

Background: Abnormal glucose metabolism is an independent risk factor for poor outcome following acute ischemic stroke. Objective: To evaluate the association between high HbA1c level and poor functional outcome in new onset ischemic stroke patient with diabetes mellitus. Method: This Cross sectional study was carried out in the Department of Neurology, BSMMU, Dhaka, from February 2013 to September 2014 on 50 patients with first attack of ischemic stroke with DM. modified Rankin Scale (mRS) and HbA1c were measured on 14th day of the stroke. During this period other important relevant investigations were also recorded. Result: Majority of the patients (40.0%) were in age group 51-60 years. The mean age was 58.9 ± 9.6 years with a range from 30 to 75 years. Males were 52.0% and females were 48.0%. Male to female ratio was 1.08:1. It was observed that more than one third (36.0%) patients were current smoker, 9(18.0%) were former smoker and 23(46.0%) were non smoker. Majority of the 29(58.0%) patients had hypertension. Mean systolic BP was found 129 ±16 mmHg with a range from 90 to 160 mmHg. The mean diastolic BP was found 81±11 mmHg with a range from 60 to 100 mmHg. HbA1c has significant positive correlation with modified ranking scale on 14th day of stroke [r= 0.504 (p<0.001)]. Conclusion: As per study result it can be concluded that increase level of HbA1c is associated with higher level of mRS. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 5-8

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Shaft of humerus fracture managed by anteromedial plating through anterolateral approach.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.06.4778 ◽

2021 ◽

Vol 28 (06) ◽

pp. 881-885

Author(s):

Masroor Ahmed ◽

Muhammad Bux ◽

Naveed Ahmed ◽

Mukesh Kumar ◽

Muhammad Ishtiyaque ◽

...

Keyword(s):

Functional Outcome ◽

Cross Sectional Study ◽

Humerus Fracture ◽

Anterolateral Approach ◽

Cross Sectional ◽

Medical College ◽

Excellent Functional Outcome ◽

Humerus Fractures ◽

The Mean ◽

Study Setting

Objective: To assess the use of anteromedial plating in the shaft of humerus fractures concerning the union of fracture and to assess the frequency of complications associated with this approach. Study Design: Cross Sectional study. Setting: United Medical and Dental College, Shaheed Muhatarma Benazir Bhutto Medical College Lyari and Khairpur Medical College. Period: 15 January 2016 to 15 January 2019. Material & Methods: All the patients aged 18 years or over presenting with the shaft of humerus fracture were included in the study. The anterolateral approach was used to expose the fracture, and the plate was applied on the anteromedial surface of the humerus. Rodriguez Merchan criteria assessed the functional outcome. All the data was recorded on designated Performa and entered and analyzed by SPSS version 20. Results: Two hundred twenty-five patients of both sexes were included in the study. The mean age of the patients in the study was 38.06 ± 11.51. The mean union time of fracture in our study was 11.76 ± 2.72 weeks. Functional outcome was assessed using Rodriguez Merchan criteria excellent functional outcome was achieved in 165(73.3%) of the cases and good functional outcome in 58 (25.8%) of cases. A fair outcome was achieved in 2 (0.9%) cases. Conclusion: Anteromedial plating is the viable option for treating shaft of humerus fractures as it is associated with a high union rate and low or no complications.

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Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50744 ◽

2020 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Mohammad Enayet Hussain ◽

Bithi Debnath ◽

AFM Al Masum Khan ◽

Md Ferdous Mian ◽

Md Nahidul Islam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Clinical Diagnosis ◽

Optic Neuropathy ◽

Cross Sectional Study ◽

P Value ◽

Pattern Reversal ◽

Cross Sectional ◽

The Mean ◽

Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

10.33798/ajmas2019/00265. ◽

2019 ◽

Vol 2 (1) ◽

pp. 1-18

Author(s):

Chijioke Okeudo ◽

B.U. Ezem

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Cross Sectional Study ◽

Fluid Volume ◽

Singleton Pregnancy ◽

Cross Sectional ◽

South Eastern ◽

Amniotic Fluid Volume ◽

The Mean ◽

Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

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Advantages and limitations of the endoscopic tympanoscopy a prospective study

10.30574/ijsra.2020.1.1.0016 ◽

2020 ◽

Vol 1 (1) ◽

pp. 012-017

Author(s):

Najib Zouhair ◽

Anass Chaouki ◽

Amine M’khatri ◽

Youssef Oukessou ◽

Sami Rouadi ◽

...

Keyword(s):

Middle Ear ◽

Operating Time ◽

Cross Sectional Study ◽

Cross Sectional ◽

Invasive Approach ◽

Intraoperative Bleeding ◽

Advantages And Disadvantages ◽

Early Return ◽

The Mean ◽

Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

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Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32638 ◽

2020 ◽

Vol 22 (3) ◽

pp. 141-145

Author(s):

Krishna Chandra Devkota ◽

S Hamal ◽

PP Panta

Keyword(s):

Pleural Effusion ◽

Cross Sectional Study ◽

Pleural Space ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical College ◽

The Common ◽

The Mean ◽

Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

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High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries

Nutrients ◽

10.3390/nu13030995 ◽

2021 ◽

Vol 13 (3) ◽

pp. 995

Author(s):

Israa M. Shatwan ◽

Eiman A. Alhinai ◽

Balqees Alawadhi ◽

Shelini Surendran ◽

Najlaa M. Aljefree ◽

...

Keyword(s):

Mediterranean Diet ◽

Total Sample ◽

Cross Sectional Study ◽

Inverse Association ◽

Protective Effects ◽

Hip Circumference ◽

Cross Sectional ◽

Gulf Countries ◽

The Mean ◽

The Mediterranean

The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20–55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.

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