ABSTRACT
Background: Carpal tunnel syndrome [CTS] is a constellation of symptoms and signs resulting from the local compression of the median nerve inside the carpal tunnel at the wrist. In advanced cases of CTS where the course is unnoticed, atrophy of the thenar muscles may occur, which can be irreversible
Objective: The aim of the present study was to estimate prevalence and severity of CTS in patients with type 2 diabetes mellitus in South Western region of the Kingdom of Saudi Arabia [KSA] and to identify specific at risk groups within these populations by using nerve conduction study
Methods: This cross-sectional study was conducted in Asir Central Hospital, Abha, KSA. The study randomly included all patients with type 2 diabetes mellitus with their place of birth and permanent residence being in Abha or Mohyel cities. History, physical examination, and laboratory data about fasting blood glucose, HbA1c, and lipid profile were collected. Additionally, nerve conduction study of both hands was performed
Results: Out of 131 included subjects, 107 patients [81.7%] had CTS. Approximately one-third [35.1%] of the study subjects had unilateral CTS, and it affected both hands in 46.6% of them. In the majority of cases CTS was of very mild or mild severity [27.5% and 26.7% respectively]. A significant association was found between gender, hypertension, hypothyroidism, ischemic heart disease and the development of CTS
Conclusion: High prevalence of unilateral and bilateral CTS was found among patients with type 2 diabetes mellitus in South Western Saudi Arabia. Different grades of CTS were detected, but the severity of functional impairment was relatively mild. Development of CTS was associated with hypertension, ischemic heart disease, and hypothyroidism. Health care professionals should be aware of this high prevalence, and it will be useful to perform electrodiagnostic studies in diabetic patients in whom CTS is suspected
ABSTRACT
Background: Anterior Cruciate Ligament [ACL] reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program
Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews
Methods: a Systematic search in the scientific database [Medline, Scopus, EMBASE , and Google Scholer] between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint [ ACL reconstruction rehabilitation ] studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed
Results: the search results yielded five studies which evaluated eight rehabilitation components [bracing, Continuous passive motion [CPM], neuromuscular electrical stimulation [NMES], open kinetic chain [OKC] versus closed kinetic chain [CKC] exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation]. A strong evidence suggested no added benefit of short term bracing [0-6 weeks post-surgery] compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction
Conclusion: short term post-operative bracing and continuous passive motion [CPM] introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1] CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term [6-14 weeks] after ACL reconstruction and 2] home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear
ABSTRACT
In spite of being rare, fat embolism syndrome is considered a fatal complication after bone fracture and orthopedic procedures. It was suggested that early immobilization might reduce the incidence of fat embolism syndrome. However, no enough data are available to justify this finding
Objectives: The aim of this review is to determine the incidence of fat embolism among patients who had long fracture fixation
Methods: A systematic review of Medline and Cochrane library was conducted on their database. This search yielded 34 papers, 13 of which were related
Results: The incidence of fat embolism syndrome after long fracture fixation ranged from 2.7% and 11%. More specifically, the incidence among long bone fracture patients who were operated early [within the first 24 hours after injury] ranged from zero% in some studies [16,19] to 1.8% in others. As regards late operation, after 24 hour of bone fracture, the incidence of fat embolism syndrome [FES] ranged from 3.5% to 10.4
Conclusions: The incidence of fat embolism in post long fracture fixation is very low. Several research works indicate that early fixation significantly reduce the incidence of FES compared to late fixation