ABSTRACT
To assess the incidence and clinical presentation of peripheral neuropathy in the cases of diabetic mellitus. Cross sectional study. This study was conducted at Medicine Department of LUMHS with the duration of time February 2011 to January 2012. Total 200 cases were chosen for this study after diagnosis of diabetic mellitus. All equitable laboratory investigations were carried out, along with HbAlC. All the cases were excluded from the study those were less than 5 HbAlc levels, history of any trauma leading to neurological deficit that can compromise assessment of sensory system along with history of renal failure. All the data regarding demographic characteristics,incidence and clinical pattern of the cases with peripheral neuropathy was entered in the predesigned Performa. Mean age of the cases was 56.3 +/- 10.21 years. Mostly cases were noted from urban area 60.0%. 46.0%cases were smoker and mostly smoker were male, while 26 [13.0%] patients [totally male] were with history of alcohol consumption. Mostly patients were poor socioeconomically. Incidence of the neuropathy was noted 60%further according to the classification, 16% cases were found with mild neuropathy, 21%were with severe while majority of the cases 32% were found with moderate neuropathy. According to the clinical presentation mostly cases were found with burning, 85.0%, Pain 66.6%, numbness 75.0%, while Sensitive touch, Itching, Foot ulcer,Muscle cramp and Tingling were found as 60 [50.0%], 36[30.0%], 18[15.0%], 45[37.5%] and 51[42.5%] respectively. In this study it is concluded that incidence of diabetic peripheral neuropathy is very high, and it increases with the increasing time of diabetes, uncontrolled diabetes and ignorance diabetes. Majority of the cases had found with sensory loss having foot ulcers, and they were unaware regarding this condition
Subject(s)
Humans , Male , Middle Aged , Female , Aged , Diabetes Mellitus , Incidence , Cross-Sectional Studies , Glycated HemoglobinABSTRACT
OBJECTIVE: Objective of this study is to determine the outcome of Burr-hole craniostomy for chronic subdural hematoma [CSDH]
STUDY DESIGN: A descriptive study
SETTING: Department of Neurosurgery, Liaquat University Hospital, Jamshoro study period 15th September 2010 to 16th March 2012
METHODS: All patients of either gender presented with clinical and radiological evidence of CSDH and undergoing burr-hole craniostomy. The outcome evaluated by postoperative improvement of patients using Glasgow Coma Scale and Markwalder scale
RESULTS: Among 33 subjects, the mean age of the patients was 65.94 years with age ranges between 30 - 88 years with majority males [63.6%]. 57.6% had history of trauma and 66.7% presented with complain of headache. A significant improvement in the Post-Operative Markwalder grade and Glasgow coma scale [p<0.01] noticed as compare to pre-operative Markwalder grade and Glasgow coma scale
CONCLUSION: Burr hole Craniostomy with closed drainage system under local anesthesia is a good choice of treatment. In CSDH, Burr hole Craniostomy is safe and results are comparable to those of the major series of the literature as the surgical procedure is standardized
ABSTRACT
OBJECTIVE: This study is conducted to document the major complications and presenting features of ventriculoperitoneal shunt
STUDY DESIGN: Prospective observational
SETTING: Department of Neurosurgery Isra University Hospital Hyderabad over a period of two years from January 2009 to December 2011
METHODOLOGY: 40 Children of either gender under the age of 12 years presented with signs and symptoms of shunt malfunction, that passed either for communicating or noncommunicating hydrocephalus, were enrolled. All patients after the admission underwent a complete clinical assessment including a detailed history and examination with particular emphasis on neurological examination. On the basis of clinical findings and investigations a final diagnosis was made and treatment in individual cases was planned accordingly. Data was analyzed by using the statistical package of social sciences [SPSS] version 16. Descriptive statistics were presented as frequency and percentages
RESULTS: Among total of 40 patients, majority were males [52.5%]. Most of the patients were under the age of one year [52.5%] and majority developed complication in the first 3 months after VP shunt insertion [35%]. Poor feeding [50%], nausea and vomiting [45%], Bulging fontanallae [45%], and dilated scalp veins [40%] were the most common presenting complaints observed. Most common complication of VP shunt was obstruction of shunt [52.5%]
CONCLUSION: A shunt implantation should be considered as a major operation, carried out by a senior neurosurgeon experienced in shunt insertion, with maximum vigilance to prevent infection and mechanical complications
ABSTRACT
The purpose of this study was to assess the patient's awareness of informed consent and to evaluate the current practice of obtaining informed consent from patients proposed for elective surgery in tertiary care hospital. Cross sectional survey. This study was conducted in Isra University Hospital, Hyderabad, Sindh from 2[nd] April 2012 to 3[rd] March 2013. This study was designed as an observational investigation and no interference was made regarding the informed consent process to the patient. The selection criteria for the patients who were interviewed were convenience sampling. All adult patients of >18 years, who were undergoing various surgical procedures were interviewed after taking verbal informed consent on the second postoperative day, when they were comfortable to answer the questions. While all those patients who were uncomfortable due to pain or other reason and were unwilling to answer the questions were excluded from the study. All the patients were asked predesigned questions related to the information they were provided before the surgery as part of standard informed consent practice. Questions were asked in local language which includes the demographic data, operative details, risk, benefit, complications of surgery, type of anesthesia and alternative treatment options etc. The data was entered on SPSS version 16. Frequency and percentages were calculated to show the results. Mean age of the patients was 34.95 +/- SD 14.236 years. 220 patients were included in the study. 183[83.18%] patients were told about the indications of surgery while 136 [61.81%] patients were not told about any complication of Surgery. Type of anesthesia was discussed in only 25[11.36%] of patients while complications of anesthesia were discussed in only 18[8.18%] of patients. 165[75%] patients were not given time to ask the questions regarding their disease or surgery. Consent by the consultants was taken in only 63[28.63%] patients. The majority of the patients knew the indication of surgery but very few were informed about the possible complications and risk of the surgery and anesthesia
ABSTRACT
Objective: To find out the frequency and patterns of cervical spine injuries at Liaquat University Hospital Jamshoro and to compare it with other studies
Study Design: Retrospective descriptive study
Place and Duration of study: Department of Neurosurgery, Liaquat University Jamshoro, from September 2005 to August 2008
Patients and Methods: The records of 46 patients between 13-70 years age presenting with cervical spine injuries were included. After resuscitation all the patients underwent thorough neurological examination. Cervical spine X-Rays and MRI advised. The retrieved data was collected on proforma. Frequencies and percentages were calculated for categorical data, whereas mean and SD were calculated for numerical data
Results: out of 46 patients 39 were males, 7 patients were females. Mean age was 33 years [range 13-70 years]. Majority [43.37%] of patients sustained injuries due to fall from height. Six [13.64%] patients sustained C1-C2 injuries, while rest of patients had lower cervical injury between C3-T1. Radiological Studies showed vertebral body fracture with subluxation in 21 [45.6%] patients whereas only subluxation without fracture was observed in 10 [21.73%] patients. About 12 [26.08%] patients developed vertebral body fracture after injury, while 3[6.51%] patients had only neurological cord injury without any bony or ligamentous injury. About 31 [67.39%] patients sustained incomplete cord injury while 15 [32.60%] patients had complete cord injury
Conclusion: Majority of patients sustained cervical spine injuries after fall. Cervical spine injuries are common in young adult males. Subluxation associated with vertebral body fractures is the most common injury pattern