ABSTRACT
Background@#Current therapies are quite unsuccessful in the management of neuropathic pain. Therefore, considering the inhibitory characteristics of GABA mediators, the present systematic review and meta-analysis aimed to determine the efficacy of GABAergic neural precursor cells on neuropathic pain management. @*Methods@#Search was conducted on Medline, Embase, Scopus, and Web of Science databases. A search strategy was designed based on the keywords related to GABAergic cells combined with neuropathic pain. The outcomes were allodynia and hyperalgesia. The results were reported as a pooled standardized mean difference (SMD) with a 95% confidence interval (95% CI). @*Results@#Data of 13 studies were analyzed in the present meta-analysis. The results showed that administration of GABAergic cells improved allodynia (SMD = 1.79;95% CI: 0.87, 271; P < 0.001) and hyperalgesia (SMD = 1.29; 95% CI: 0.26, 2.32; P = 0.019). Moreover, the analyses demonstrated that the efficacy of GABAergic cells in the management of allodynia and hyperalgesia is only observed in rats. Also, only genetically modified cells are effective in improving both of allodynia, and hyperalgesia. @*Conclusions@#A moderate level of pre-clinical evidence showed that transplantation of genetically-modified GABAergic cells is effective in the management of neuropathic pain. However, it seems that the transplantation efficacy of these cells is only statistically significant in improving pain symptoms in rats. Hence, caution should be exercised regarding the generalizability and the translation of the findings from rats and mice studies to large animal studies and clinical trials.
ABSTRACT
Background and objective: Thyroidectomy is an operation that involves surgical removal of all or part of the thyroid gland. The main postoperative complications of thyroidectomy are hypoparathyroidism and recurrent laryngeal nerve injury. This study aimed to find out the main postoperative complications particularly nerve damage during total thyroidectomy or total lobectomy
Methods: The medical records of patients who were diagnosed with thyroid disease and underwent surgery between January 2[nd], 2013 and December 30[th], 2014 in Teaching, Shar, Soma and Zhian hospitals in Sulaimaniyah were retrospectively reviewed
Results: All patients who underwent total thyroidectomy or total lobectomy surgeries were discharged within 24 hours of the operation. During the average follow-up of 24 months, no case of permanent recurrent laryngeal nerve injury was registered. Vocal cord paralysis was considered to be present, when there was absent or markedly reduced movement of the affected vocal cord
Conclusions: Meticulous hemostasis and a delicate technique are required to prevent nerve injury. We recommend dissection and division of all the vessels flush with the thyroid capsule at the anterior and peripheral aspect of the gland. Separate ligation of anterior and posterior branched of the superior thyroid artery will preserve the external branch of the superior laryngeal nerves