Clinical patterns of cerebral palsy with complications and neurodisabilities associated with cerebral palsy

Cerebral palsy was a primary neuromotor disorder that affects the development of movement, muscular tone and posture due to injury to the developing brain in prenatal, natal, or post-natal period. cp is non progressive disease but it is changeable features with period. The objective of this study is to identify clinical types of cerebral palsy and neuro-disabilities associated with cerebral palsy patient. Data (2019-2020) on 100 children of cerebral palsy in central teaching hospital in Baghdad analysis include clinical patterns of cerebral palsy and topographic classification of spastic cerebral palsy. also, the complication and neurological disabilities associated with cerebral palsy. In this analysis found most of cerebral palsy patients (84%) were spastic according to topographic classification, (47%) of spastic cerebral palsy was diplegic type. (29%) quadriplegic cerebral palsy and (8%) of hemiplegic cerebral palsy. About neurological complication and disabilities associated with cerebral palsy, (79%) of cerebral palsy patients had speech disturbance. (53%) had epilepsy, (43%) Micro acephaly, (32%) of patients had growth retardation, (29 %) had ocular problems, and (15%) of cerebral palsy patients had mental retardation. In conclusions; the most common type of cerebral palsy was spastic cerebral palsy & according to a topographic classification diplegic spastic cerebral palsy was the most common type of Spastic cerebral palsy. About neurodisabilities associated with cerebral palsy, the most common disabilities were speech disturbance and epilepsy.

The role of thyroid stimulating hormone in the timing of thyroxin supplement after thyroid operations

Thyroid Stimulating Hormone (TSH) levels can be measured accurately down to a very low serum concentration with an immunoassay. When the serum TSH level is in the normal range, measuring the T3 and T4 levels is redundant. The objective of this study is to study the relation of TSH levels postoperatively in thyroid surgeries with the timing for thyroxin treatment as a supplemental and suppressive therapy. A prospective cohort study was done on 84 patients underwent thyroid operations in Al-Yarmouk Teaching Hospital from March 2010 through November 2012. Patients underwent different thyroid operations (lobectomy, subtotal thyroidectomy and total thyroidectomy) for different thyroid pathology. Later, they were followed up by TSH assay in periods of 2, 4, 6 and 12 months postoperatively. Variables were compared by using the analysis of variance, ANOVA test. P – values equal or less than 0.05 and 0.01 were considered to be statistically significant and highly significant, respectively. The mean age of patients was 43.30 ± 10.19 years. The females made the vast majority of study sample (85.7%). Patients were divided into six groups: simple colloid goiters (17 patients), multinodular goiters (32 patients), solitary thyroid nodules (11 patients), Hashimoto’s thyroiditis (8 patients), Graves’ disease (8 patients) and papillary and follicular carcinomas (8 patients). The study revealed that all patients with malignant thyroid nodules (i.e. those with total thyroidectomies) and the vast majority of patients with Hashimoto’s thyroiditis were in definite need for thyroxin treatment post-operatively. Other patients were variable in their need and timing of treatment according to the histopathological results and the type of operations. In conclusion; measurement of TSH level postoperatively is a good indicator for need of thyroxin treatment and for dose adjustment with the help of pathological results and the type of surgery.

Efficacy of epidural injection of steroid in treatment of lumber disc prolapse: article review

"Chronic low back and lower extremity pain is mainly caused by lumbar disc herniation (LDH) and radiculitis. Various surgery and nonsurgical modalities, including epidural injections, have been used to treat LDH or radiculitis. Caudal epidural injection of local anesthetics with or without steroids is one of the most commonly used interventions in managing chronic low back and lower extremity pain. To describe the indications, rationale, techniques, alternatives, contraindications, complications, and efficacy of lumbar and caudal epidural corticosteroid injections. Interventions: Three reviewers with formal training and certification in evidence-based medicine searched the literature on non–image guided lumbar interlaminar epidural steroid injections. A larger team of seven reviewers independently assessed the methodology of studies found and appraised the quality of the evidence presented. A systematic literature search was performed, in the Medline Case reports and retrospective and prospective studies were extensively reviewed to provide detailed descriptions of the clinical features of lumbar and caudal epidural corticosteroid injections. Data sources included relevant literature of the English language identified through searches of PubMed and EMBASE , and manual searches of bibliographies of known primary and review articles. Epidural corticosteroid injections are commonly requested treatments for patients with various low-back or lower-extremity pain syndromes (or both). Most of the reports on the use of this type of treatment are retrospective and noncontrolled. These studies indicate benefit; however, the prospective controlled studies provide varied results about the efficacy of lumbar and caudal epidural corticosteroid injections. In conclusions: In patients with lumbar radicular pain secondary to disc herniation or neurogenic claudication due to spinal stenosis, interlaminar epidural steroid injections appear to have clinical effectiveness limited to short-term pain relief. Therefore, in a contemporary medical practice, these procedures should be restricted to the rare settings where fluoroscopy is not available."

Prevalence of sinonasal anatomical variations and their effect on chronic rhinosinusitis in Al-Ramadi teaching hospital, Ramadi city, Iraq

Anatomical variations (AVs) of the nose and paranasal sinuses (NPS) are quite common findings on CT scans. However, their effect on chronic rhinosinusitis (CRS) is still controversial. The objectives of this study is to estimate the prevalence of AVs of the NPS on CT scans and to assess the association between multiple versus single variant and CRS. A cross-sectional study was conducted in the Al-Ramadi Teaching Hospital during the period from January 1, 2018, to March 31, 2019. We reviewed the CT scans of the patients with suggestive symptoms and signs of CRS. Out of 203 CT scans, there were 153 (75.4%) scans associated with AVs of the NPS (group A). Seventy-eight with and 75 without radiological features of sinusitis. While group B (n=50 24.6%) were not detected any variants, 24 with and 26 without features of sinusitis. There was no statistically significant difference between the two groups (p-value>0.05). There were 11 AVs detected. The septal deviation of 63% was the commonest one. Most of the AVs of the NPS were multiple (2 or more) 99 (64.7%). Forty-nine (49.5%) of them were associated with features of sinusitis. There was a statistically significant difference (p-value <0.05) between those with multiple and those with single AVS concerning the radiological features of sinusitis. In conclusion; AVs of the sinonasal region were common findings on CT scans. A deviated nasal septum is the commonest AVs. Most of our patients contain more than 2 AVs, and they were more vulnerable to sinusitis.

Heavy metals and carcinogenesis: a review

There has been a growing recognition regarding heavy metal toxicity owing to their position in cancer induction. The study is linked to heavy metals like titanium, arsenic, beryllium, cadmium, lead, mercury, nickel and radium. A meta-analysis was compiled using PubMed to determine existing exposure channels, forms of cancers caused, and treatment interventions for the metals. It was planned to lead potential study activities linked to heavy metals and cancer.

Comparative study between usage of medicine containing a mixture of Dapoxetine and Tadalafil with the usage of these drugs separately in treatment of rapid ejaculation

A study was conducted on 58 patients aged from 18-63 years old, they suffering from rapid ejaculation and all their Intravaginal ejaculation latency time (IELT) were less than 2 minutes. This study done at Erectile dysfunction unit in Al-Muthana teaching hospital for a period of 1 month (March/2019). The patients were divided into 2 groups: Group 1: Patient received 30 mg of Dapoxetine 1hr before coitus and 10 mg of Tadalafil 30 min before coitus. Group 2: Patient received Dapoxetine 20 mg + Tadalafil 10 mg mixed in one tablet 1 hr before coitus. The result of our study revealed that the IELT before treatment was less than 2 minutes in both groups, after treatment the IELT increased significantly (P≤0.05) in group 1 and group 2 (337.9±3.72 and 222.4±2.88 seconds) respectively. The IELT in group 1 was increased significantly (P≤0.05) compared to IELT in group 2 after treatment. In conclusion, the administration of Dapoxetine before 1 hr. of coitus and Tadalafil 30 min. before coitus (G1) gave a good results in increasing of IELT as compared to mixture of these drugs in one tablet.

Update options in the treatment of coccydina(tail bone pain): article review

This literature review is intended to provide oversight on the anatomy, incidence, etiology, presentation, diagnosis, and treatment of coccydynia. Relevant articles were retrieved with PubMed using keywords such as “coccydynia”, “coccyx”, “coccyx pain”, and “coccygectomy. Literature accumulated for this study was accumulated from PubMed using sourcombined to form this study. Images were also added from three separate sources to aid in the understanding of the coccyx and coccydynia. Focal points of this study included the anatomy of the coccyx, etiology and presentation of coccydynia, how to properly diagnose coccydynia, and possible treatments for the variety of etioloces. The coccyx morphology is defined using different methods by different authors as presented in this study. There is no conclusive quantitative data on the incidence of coccydynia; however, there are important factors that lead to increased risk of coccydynia such as obesity, age, and female gender. Injury to the coccyx or coccygeal joints with surrounding tissue inflammation and contraction of the muscles attached to the coccyx causes coccydynia. Diagnosis is made predominantly in clinical examinations with static standard radiographs, CT, and routine blood tests. Treatment options include conservative care, physical therapy, intrarectal massage and manipulation, sacrococcygeal injections (including ganglion impar block), and coccygectomy. Many cases are resolved with conservative treatments, despite the wide array of etiologies for the diagnosis. In more extreme cases, physician intervention requires a multidisciplinary approach. Surgical treatment is used as a last resort.

Comparison of surgical out come between virgin carpal tunnel syndrome and previous local steroid injected tunnel

Carpal tunnel syndrome(CTS) is the most commonly occurring peripheral nerve compression neuropathy and its condition characterized by an abnormality of the median nerve function due to compression of the nerve within the carpal tunnel. Surgical release of the transverse carpal ligament is an effective treatment for patients with CTS. Non-steroidal anti-inflammatory drugs, diuretics, vitamin B6 injection, ultrasound therapy, laser therapy, acupuncture, magnetic therapy, bracing and local steroid injections have been used for closed treatment of CTS and effective results in the short-term treatment have been demonstrated clearly only for bracing and local steroid injections. Aim: was to identify the effect of local steroid injection on the outcome of surgical release of CTS. A prospective study that was conducted in the Orthopedic Department of at Basra General Hospital during the period from 1st of July 2005 till end of September 2006 on 40 patients, 20 of them with received local steroid injection (group A) and 20 without local steroid injection (group B virgin carpal tunnel) operations done to release the tunnel with monthly follow up by telephone call because of social and security problems at time of study. Pearson’s Chi–square test was used to assess statistical association between injection of local steroid and outcome of CTS surgery. A level of P – value less than 0.05 was considered significant. Postoperatively, in Group A, night pain and grip power were found to be improved in 17 (85%) and 11 (55%) of women, respectively, while 16 (80%) relieved from night pain, paresthesia and numbness. On the other hand, the postoperative follow up of women in group B showed that the improvement of night pain was occurred in 20 cases (90%), relieving of night pain, paresthesia and numbness in 17 (85%), and improvement of grip power was reported in 12 (60%). The analysis of association didn’t show statistical significant difference (P > 0.05) in surgical outcome between study groups. In conclusion; local steroid injection for CTS prior to surgery didn’t affect outcome of surgical release.

Comparison of the healing effect of occlusive hydrocolloid dressing and conventional gauze dressing concerning hernia operations in children

The purpose is using the occlusive hydrocolloid dressing (OHD) and gauze dressing (GD) to compare incidence of infection of wound and cost-effectiveness of dressing after hernia operation in children. Eighty children was undergo hernia surgery, wounds were dressing by OHD or GD. Hydrocolloid dressing was remain till suture was removed, and GD changed every day after operation. Calculations of cost dressing mean dressing alterations frequency and cost for each dressing in every treatment cluster. There are no variances amongst the two clusters concerning the incidence of wound infection. OHD was less costly and complex than GD, and GD necessary to be altered each day (p = 0.001). In conclusion, OHD is less costly to use, and less complex than GD because GD wanted to be altered more times during the period of healing.

Immunotherapy and prevention of breast cancer

Breast cancer is the most commonly diagnosed cancer in women and is a leading cause of cancer death in women worldwide. Despite the significant benefit of the use of conventional chemotherapy and monoclonal antibodies in the prognosis of breast cancer patients and although the recent approval of the anti-PD-L1 antibody atezolizumab in combination with chemotherapy has been a milestone for the treatment of patients with metastatic triple-negative breast cancer, immunologic treatment of breast tumors remains a great challenge. In this review, we summarize current breast cancer classification and standard of care, the main obstacles that hinder the success of immunotherapies in breast cancer patients, as well as different approaches that could be useful to enhance the response of breast tumors to immunotherapies.