Cervical malalignment after laminoplasty: relationship to deep extensor musculature of the cervical spine and neurological outcome

2007 ◽  
Vol 7 (6) ◽  
pp. 610-614 ◽  
Author(s):  
Haku Iizuka ◽  
Takashi Nakajima ◽  
Yoichi Iizuka ◽  
Yasunori Sorimachi ◽  
Tsuyoshi Ara ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neurological Outcome ◽  
Neurological Recovery ◽  
Cervical Lordosis ◽  
Cervical Alignment ◽  
Female Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Relationship

Object The goal of this study was to investigate the relationship between preservation of the insertion of the deep extensor musculature of the cervical spine at C-2 and postoperative cervical alignment, especially differences between cases involving male and female patients, as well as the relationship between the loss of cervical lordosis and neurological outcome after laminoplasty. Methods The authors reviewed the records of 50 patients who underwent laminoplasty to elevate the C-3 lamina with repair of the deep extensor musculature (Group A) and 31 patients who underwent laminoplasty by C-3 dome laminotomy or laminectomy (Group B). They compared the degree of cervical lordosis after laminoplasty with preoperative measurements. Neurological function at last follow-up was also compared with preoperative assessments. Results In Group A, the mean values for pre- and postoperative cervical lordosis were 14.5 and 10.9°, respectively (p > 0.18). In female patients, however, the pre- and postoperative means were 14.4 and 3.7°, respectively (p < 0.004). In Group B, the overall means for pre- and postoperative cervical lordosis were 17.3 and 19.1°, respectively (p > 0.48); the corresponding means for female patients were 15.0 and 14.1° (p > 0.83). The mean percentages of neurological recovery were 54.1% in Group A and 54.8% in Group B. Conclusions Preservation of the insertion of the deep extensor musculature to the C-2 spinous process prevented significant changes in cervical alignment after laminoplasty, even among female patients. Neurological recovery was not affected by the loss of cervical lordosis.

Comparison between aspiration and incision and drainage of breast abscess

2020 ◽  
Vol 22 (1) ◽  
pp. 11-15
Author(s):  
Md Fardhus ◽  
AMSM Sharfuzzaman ◽  
Md Nayeem Dewan ◽  
Dipak Chandra Kirttania ◽  
Ahmed Sami AI Hasan ◽  
...  
Keyword(s):  
Bacterial Colonization ◽  
Needle Aspiration ◽  
Cosmetic Outcome ◽  
Breast Abscess ◽  
Incision And Drainage ◽  
Female Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Drainage Group

Background: Breast abscess is defined as an acute inflammatory lump which yields pus on incision/aspiration. The frequency of occurrence is highly related to pregnancy and caused due to nipple cracking by a child during breast feeding and bacterial colonization due to improper nursing technique and incomplete emptying of the breast. Objective: The present study compares the outcome and effectiveness of traditional treatment incision and drainage against needle aspiration in the treatment of breast abscess. Methods: This is a comparative study carried out in department of general surgery, SherE- Bangla Medical College Hospital, Barisal between January 2014 and December 2014. 50 female patients of age between 20-40 years and diagnosed breast abscess with abscess size of 5'7 cm in diameter on ultrasonography were included in the study after taking written consent form. Of these 25 had undergone aspiration of the breast abscess (group A) and 25 had undergone incision and drainage (group B). Results: The mean age of the female patients in group A was 23.42 years and in Group B was 23.31. 91% of the cases were lactating. S. aureus was the common organism isolated in both lactating and non-lactating cases, encountered in 27 patients (54%). Out of that were in the aspirated group 17patients (56.67%). 10 patients were in the incised group (33.33%). The mean healing time and cosmetic outcome was significantly (p =0.001) very good in patients treated with needle aspiration compared to incision and drainage. There was no recurrence of breast abscess observed in needle aspiration group during the study. There was 3.3% recurrence rate observed in the incision and drainage group. Conclusion: Breast abscess in patients with diameter of 5'7 cm can be treated with needle aspiration successfully and with a good cosmetic outcome. Journal of Surgical Sciences (2018) Vol. 22 (1): 11-15

scholarly journals Efficacy and adverse events related to the initial dose of methimazole in children and adolescents with Graves’ disease

2021 ◽  
Vol 26 (3) ◽  
pp. 199-204
Author(s):  
Hyun Gyung Lee ◽  
Eun Mi Yang ◽  
Chan Jong Kim
Keyword(s):  
Adverse Events ◽  
Children And Adolescents ◽  
Liver Dysfunction ◽  
Initial Dose ◽  
Graves Disease ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Relationship ◽  
Mean Time

Purpose: The first-line antithyroid drug for children and adolescents with Graves’ disease (GD) is methimazole (MMI). This study evaluated the relationship between the initial MMI dose and the clinical course of GD after treatment.Methods: We studied the efficacy of the initial MMI dose and the relationship between the initial MMI dose and adverse events (AEs). We retrospectively enrolled 22 males and 77 females and divided those subjects into 3 groups according to the initial dose of MMI: <0.4 mg/kg/day (group A; n=32); 0.4–0.7 mg/kg/day (group B; n=39); and >0.7 mg/kg/day (group C; n=28).Results: The mean time to the normalization of free thyroxine (fT4) levels upon initial treatment was 5.64, 8.61, and 7.98 weeks in groups A, B, and C, respectively (P=0.116). The incidence of liver dysfunction, neutropenia, and skin rash was 12.5%, 20.5%, and 42.9% in groups A, B, and C, respectively (P=0.018). Neutropenia, as a severe AE, was absent in group A, but its prevalence was 7.7% in group B and 21.4% in group C (P=0.015). When comparing only groups B and C, the incidences of liver dysfunction and neutropenia were higher in group C (P=0.04 and P=0.021, respectively).Conclusion: The mean time to the normalization of fT4 levels did not differ among the 3 groups, but the incidence of AEs was higher in the groups that received high MMI doses. High doses of MMI (>0.7 mg/kg/day) should be reconsidered as an initial treatment for children and adolescents with GD.

Cervical sagittal plane decompensation after surgery for adolescent idiopathic scoliosis: an effect imparted by postoperative thoracic hypokyphosis

2011 ◽  
Vol 15 (5) ◽  
pp. 491-496 ◽  
Author(s):  
Steven W. Hwang ◽  
Amer F. Samdani ◽  
Mark Tantorski ◽  
Patrick Cahill ◽  
Jason Nydick ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Adolescent Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
Thoracic Kyphosis ◽  
Sagittal Plane ◽  
Cervical Kyphosis ◽  
Group A ◽  
Group B ◽  
The Relationship

Object Several studies have characterized the relationship among postoperative thoracic, lumbar, and pelvic alignment in the sagittal plane. However, little is known of the relationship between postoperative thoracic kyphosis and sagittal cervical alignment in patients with adolescent idiopathic scoliosis (AIS) treated with all pedicle screw constructs. The authors examined this relationship and associated factors. Methods A prospective database of pediatric patients with AIS undergoing spinal fusion between 2003 and 2005 was reviewed for those who received predominantly pedicle screw constructs for Lenke Type 1 or Type 2 curves. Parameters analyzed on pre- and postoperative radiographs were the fusion levels; cervical, thoracic, and lumbar sagittal balance; and C-2 and C-7 plumb lines. Results Preoperatively, 6 (Group A) of the 22 patients included in the study had frank cervical kyphosis (mean angle 13.0°) with mean associated thoracic kyphosis of 27.2° (range 16°–37°). Postoperatively, cervical kyphosis (13.0°) remained in the patients in Group A along with mean thoracic kyphosis of 17.7° (range 4°–26°, p < 0.05). Preoperatively, the remaining 16 of 22 patients had neutral to lordotic cervical alignment (mean −13.8°) with thoracic kyphosis (mean 45°, range 30°–76°). Postoperatively, 8 (Group B) of these 16 patients demonstrated cervical sagittal decompensation (> 5° kyphosis), with 6 showing frank cervical kyphosis (10.5°, p < 0.05). In Group B, the mean postoperative thoracic kyphosis was 25.6° (range 7°–49°, p < 0.05). The other 8 patients (Group C) had mean postoperative thoracic kyphosis of 44.1° (range 32°–65°), and there was no cervical decompensation (p < 0.05). Conclusions The sagittal profile of the thoracic spine is related to that of the cervical spine. The surgical treatment of Lenke Type 1 and 2 curves by using all pedicle screw constructs has a significant hypokyphotic effect on thoracic sagittal plane alignment (19 [86%] of 22 patients). If postoperative thoracic kyphosis is excessively decreased (mean 25.6°, p < 0.05), the cervical spine may decompensate into significant kyphosis.

Lumbar Canal Stenosis: A Prospective Clinicoradiologic Analysis

2020 ◽  
Vol 81 (05) ◽  
pp. 387-391
Author(s):  
Nikhil Jain ◽  
Shankar Acharya ◽  
Nitin Maruti Adsul ◽  
Mukesh Kumar Haritwal ◽  
Manoj Kumar ◽  
...  
Keyword(s):  
Back Pain ◽  
Spinal Canal ◽  
Neurogenic Claudication ◽  
Canal Stenosis ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Relationship Of ◽  
The Relationship

Abstract Background Although spinal canal narrowing is thought to be the defining feature for the clinical diagnosis of lumbar canal stenosis, the degree of spinal canal stenosis necessary to elicit neurologic symptoms is not clear. Several studies have been performed to detect an association between a narrow spinal canal and clinical symptoms. Through our prospective study, we compared the radiologic criteria with the clinical criteria using the Oswestry Disability Index (ODI) and assessed how they correlate. Materials and Methods We used the qualitative grading (morphological classification system on magnetic resonance imaging [MRI]) system, dural sac cross-sectional area (DSCA), and sedimentation sign on MRI images and compared them with the Self-Paced Walking Ability (Self-Paced Walking Test) and ODI of the patients in the study. The systems were applied to 85 patients divided into three groups: group A: 43 patients with neurogenic claudication and able to walk < 30 minutes; group B: 11 patients with neurogenic claudication and able to walk > 30 minutes; and group C: 31 patients with simple back pain and no signs of neurologic claudication. Results The mean ODI was 21.19 in group C, 46.50 in group B, and 61.95 in group A. The difference was statistically significant. The mean DSCA was 164.42 mm2 in group C, 49.94 mm2 in group B, and 35.07 mm2 in group A. The difference was statistically significant. The sedimentation sign was negative in 96.8% patients in group C, 54.5% patients in group B, and 32.6% patients in group A. The difference was statistically significant. Group C had 9.3% patients in morphology grade A3, 51.6% in grade A2, and 38.7% patients in grade A1. Group B had 63.6% patients in grade C, 18.2% patients in grade B, 9.1% in grade A4, and 9.1% in grade A3. Group A had 18.6% patients in grade D, 39.5% in grade C, 27.9% in grade B, 11.6% in grade A4, and 2.3% in grade A3. The mean DSCA of group C was significantly different from group A and group B, but the difference of the mean DSCA between group A and group B was not statistically significant. The relationship of ODI to DSCA, ODI to sedimentation sign, and ODI to morphological grading for group C and group A was not statistically significant. The relationship of morphological grading to DSCA was statistically significant for all three groups. Conclusion DSCA, morphological grading, and sedimentation sign are good to excellent radiologic indicators differentiating patients with simple back pain from those with lumbar spinal stenosis. Clinically, ODI is an excellent indicator of the severity of stenosis. But ODI statistically has no significant correlation to any of these radiologic parameters.

scholarly journals Serum Ferritin as a Risk Factor for Myocardial Infarction

1970 ◽  
Vol 16 (1) ◽  
pp. 5-7
Author(s):  
MS Hafiz ◽  
MI Arslan ◽  
S Banarjee ◽  
M Obaidullah
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Serum Ferritin ◽  
Ferritin Level ◽  
Premature Death ◽  
High Serum ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Relationship

Myocardial Infarction (Ml) is the most common form of heart disease and the single mostimportant cause of premature death in the developed and developing world. Unfortunately theincidence of the condition is increasing rapidly in many developing countries like Bangladesh.Effort should therefore be taken to minimize the risk factors of Ml. There are several studieswhich evaluate the relation of serum ferritin with Ml in abroad. In Bangladesh, there is no suchstudy was carried out to evaluate the relationship between serum ferritin and Ml. So the presentwork has been designed to evaluate the association of serum ferritin with Ml.The present study was carried out in the Department of Biochemistry, BSMMU in collaborationwith Department of Cardiology, BSMMU and NICVD, Dhaka during the period of July 2001 toDecember 2002. A total of 50 subjects were selected, Group A ( 20 subjects of Ml) and Group B(30 subjects of Control). The mean level of serum ferritin in control subjects were 111.65 ±50.47 ng/ml and in test subjects were 258.44 ± 87.87 ng/ml. So the present study showed thatserum ferritin level is significantly higher in patients with Ml. From the present study, it isdifficult to draw any definite conclusion but suggested that high serum ferritin concentrationmay be a cause of the incidence of Ml.doi: 10.3329/taj.v16i1.3893TAJ June 2003; Vol.16(1): 5-7

scholarly journals Evaluation of Adjacent Segment Degeneration after Cervical Spine Surgery: Arthroplasty versus Fusion

2013 ◽  
Vol 2 (1) ◽  
pp. 12-17
Author(s):  
Saeed Hamidi ◽  
Neda Fahimi ◽  
Ehsan Jangholi ◽  
Mohammad Ali Fahimi ◽  
Ali Farshad ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Disability Index ◽  
Cervical Radiculopathy ◽  
Adjacent Segment Degeneration ◽  
Cervical Disc ◽  
Adjacent Segment ◽  
Increased Risk ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Anterior Cervical Discectomy and Fusion (ACDF) is an effective treatment for disc herniations; but some studies demonstrated that in the untreated levels adjacent to a fusion, increased motion might lead to an increased risk of adjacent segment degeneration (ASD). On the other hand, methods of cervical Disc Arthroplasty (CDA) have improved. The aim of this study is to evaluate and compare the rate of ASD in patients who underwent ACDF or CDA cervical spine surgery.Methods and Materials: This prospective study was performed on 84 patients with cervical radiculopathy due to single-level disc herniation referred to hospitals in Tehran, Iran from June 2011 to December 2012. All subjects were randomly allocated to Group A or Group B to undergo ACDF or CDA, respectively. The validated Neck Disability Index (NDI) questionnaire was used to assess the cervical neck pain.Results: The mean of age in Group A was 51.7 ± 9.1 years and in Group B was 49.3 ±9.2. The differences in cervical radiculopathy in the two groups were not statistically significant. The difference in mean Visual Analogue Scale (VAS) score in the two groups at each assessment time was statistically significant. Mean NDI score before the surgery was 46.9 ± 6.1 in group A, and 41.3 ±4.7 in group B. The mean NDI score improved significantly in group B. Twenty-seven of the patients in Group A experienced ASD at 12 months compared to one patient (2.3%) in Group B (p<0.05).Conclusion: According to the findings of this study, CDA leads to reduced VAS and NDI score compared to ACDF. Also increased ASD in ACDF was demonstrated when compared with CDA after 1-year follow-up.

scholarly journals PHOTOTHERAPY

2015 ◽  
Vol 22 (08) ◽  
pp. 1071-1075
Author(s):  
Farhan Ahmed ◽  
Ali Hasan ◽  
Noormah Mehmood
Keyword(s):  
Hospital Stay ◽  
Duration Of Stay ◽  
Female Patients ◽  
Group A ◽  
Random Number Table ◽  
The Mean ◽  
Randomized Control ◽  
Conventional Methods ◽  
Group B ◽  
Neonatal Ward

Objective: To compare mean duration of stay (in hours) of patients with newimprovised versus conventional methods of phototherapy among neonates with jaundice.Study Design: Randomized control trial. Period: Six months. Setting: Neonatal ward,Department of Paediatric Medicine, Lahore General Hospital, Lahore. Subjects and Methods:160 patients, with the help of random number table, all the patients were randomly dividedinto 2 groups A and B, after getting the informed consent from their parents. Group A patientsreceived conventional phototherapy. Group B patients received phototherapy with reflectingmirrors placed beneath and at the side of the patient in baby’s cot (new improvised methodof phototherapy). Results: In this study the mean age of patients in group-A and group-Bwas 2.70±1.13 days and 2.12±1.98 days respectively. In group-A there were 47 (58.75%)male and 33 (41.25%) female patients while in group-B there were 51 (63.75%) male and 29(36.25%) female patients. According to hospital stay, the mean hospital stay in group A was39.76±11.80 hours and in group-B it was 44.90±14.21 hours, the mean hospital stay wasstatistically significant (p<0.001) Conclusion: Shorter mean duration of stay (in hours) wasrecorded in patients treated with new improvised as compared to conventional methods ofphototherapy among neonates with jaundice, the data is primary in our country, this techniquemay be used further but after some more trials to confirm its efficacy regarding shorter durationof hospital stay

scholarly journals Incidence of Thrombocytopenia in Idiopathic Hyperbilirubinemic Newborns

2014 ◽  
Vol 2 (2) ◽  
pp. 261-264
Author(s):  
Hassan Boskabadi ◽  
Shahin Mafinezhad ◽  
Fatemah Bagher ◽  
Yasaman Bozorgnia
Keyword(s):  
Serum Bilirubin ◽  
Neonatal Period ◽  
Coombs Test ◽  
Significant Difference ◽  
Group A ◽  
Laboratory Variables ◽  
The Mean ◽  
Group B ◽  
The Relationship ◽  
Reason For Admission

Background: Hyperbilirubinemia is the most common reason for admission during the neonatal period and may develop serious complications. Thrombocytopenia is defined as platelet count <150,000/mm3 and has not been conclusively reported as a complication of hyperbilirubinemia in any of the standard paediatric textbooks. The aim of this study was to find the incidence of thrombocytopenia in neonates with idiopathic jaundice and the relationship between hyperbilirubinaemia and platelet count.Methods: This was a descriptive-analytic study accomplished on 878 newborns. After a detailed history, clinical examination and baseline investigations,185 babies with idiopathic hyperbilirubinemia were tested for platelet counts and then categorized in two groups namely group A (n=65) and group B (n=120) showing the presence and absence of thrombocytopenia, respectively. Newborns data were recorded and Statistical analysis was carried out, using SPSS 11.5.Results: The incidence of thrombocytopenia was seen in 65 (12%) newborns admitted due to jaundice. The mean serum bilirubin in group A and B was defined as 19.7 (± 6) and 20.4 (± 5), respectively (P = 0.362).There was no significant difference in Laboratory variables likeTSH, T4, coombs test, reticulocite count, serum sodium and hematocrit values between two groups.Conclusion: This study determines higher rate of thrombocytopenia among idiopathic hyperbilirubinemic neonates (36%) and helps the practitioner to be aware of this association and avoid unnecessary investigations.We did not find a significant correlation between serum bilirubin values and thrombocytopenia.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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