Carpal tunnel release in diabetic and non-diabetic patients

Carpal tunnel syndrome [CTS] is a compression neuropathy that causes paresthesia, pain or numbness in the territory of median nerve. The aim of this study is to compare the open surgery outcome and patients' satisfaction in carpal tunnel syndrome among diabetic and non-diabetic patients. In a retrospective cohort study from April 2011 to June 2012, patients suffered from carpal tunnel syndrome at least 6 months, without response to conservative treatment, who had the inclusion and exclusion criteria, were evaluated by the usage of MHQ and WHOQOL-BREEF tests, one month before surgery and three months after that. Carpal tunnel decompression surgery was performed by two surgeons, experienced in hand surgery, which used the same surgical method. Statistical analysis was performed by SPSS 19.0, 24 of patient [34,2%] were male and 46 [65.8%] were female and there was no significant difference between two groups [P>0.05]. MHQ total score before and after surgery was respectively 50.22 +/- 7.13 and 63.49 +/- 11.28 and this difference was significant [P<0.05]. In WHOQOF-BREEF parameters, physical parameters [36.81 +/- 19.8 vs. 55.30 +/- 24.36] and psychological parameters [41.64 +/- 14,77 vs. 61.24 +/- 19.9] improved significantly after surgery. The outcome of carpal tunnel syndrome open surgery is good in both men and women, but diabetes has a negative impact on surgery outcome in short term

Lumbosacral tethered cord syndrome [a review of 27 cases]

Tethered cord syndrome is a neurological disorder that is accompanied by limited movement of spinal cord within the spinal column. This study aimed to describe clinical features, surgery treatment and long term outcomes in these patients. This prospective study carried out from 1997 to 2007 on we selected 27 patients with lumbosacral tethered cord syndrome, neurological findings and positive MRI. Operation was performed clinical and neurological and imaging findings and their etiologies were recorded. Follow up was achieved in three periods for studying and reviewing of their neurological and scoliosis recovery. Data analyzed by descriptive statistics and frequency distributes tables by SPSS software. Sixteen patients were male and 11 were female. 22 cases were younger than 7 and 5 other cases were between 17 to 33. After 3 years, most of disorders were recovered. The best results were due to LBP, motoric disorder, dysesthesia and muscle cramps in lower limbs. Three Patients had CSF leakage and one patient had pseudomeningocele after operation. Surgery is recommended for resection of lesion, cord detethering or resection of tight filum terminal and adhesions. Results of surgical treatment are excellent especially in younger patients. In children, surgery is achieved for prevention of progressive neurological disorders. Cord detethering in adults, diminishes the size of cord cysts and prevents of progressive clinical and neurological disorders

[Penetrating traumas to base of skull]

Penetrating traumata's to the skull is important cause of death special in industrial societies. The present study was done on twenty cases of penetrating traumas to base of skull; and patients were studied for Epidemiology, clinical symptoms, treatment procedures, evolution and prognosis. This research was done in a retrospective method on patients admitted to Mashhad Emdadi Hospital [Mashhad Emergency Hospital] from September 2003 to January 2004. Data concerning cause of incidence, clinical symptom, accompanying damage, procedures taken, and kind of treatment and prognosis were studied in all patients. On this study all twenty patients were male ranging in age from 20 to 58 years. Causes for hospital admittance were; fighting 17 cases [80%] war injuries, 3 cases and suicide, 1 case [5%]. [65%] received medical treatment and seven cases received surgery [35%] Surgery included extraction of hematoma from brain tissue or Subdural, brain debridement, repair of depressed skull fracture and orbit. Thirteen patients were treated concretively and seven patients had surgical operation and five died during treatment. Primary low GCS, shock and hypertension upon hospital admission abnormal pupil and high age of the person were all influential factors causing high-rate death level in patients. In addition to the result of this study, the literature show quick primary cure and accessibility to medical center are extremely important factors to decrease death rate and lessen damage due to penetrating trauma to the skull