Outcome of anterior cervical discectomy with cage in cervical disc degeneration

This study evaluates the efficiency and outcome of interbody polyetheretherketone [PEEK] cage implantation in 50 consecutive cases treated, for cervical disc degeneration. This work was conducted in Assiut University Hospital, Neurosurgery Department over 3 ears duration from 2006 to 2009. Fifty patients with cervical disc disease, were treated with cervical discectomy and Cervical interbody fusion using a PEEK cage. PEEK cages were packed with demineralised bone grafts or synthetic bone grafts. Additional plating was not used in any case. The median duration of follow-up was 12 Months [range, 6-36 months]. Cervical x-rays were routinely used in the follow-up to assess the fusion pseudoarthrosis, kyphosis, cage migration, subsidence or breakage. There were 39 male and 11 female patients and the mean age 45 years [range, 30-60 years]. No implant insufficiency or significant complications was observed in any case. The use of a cervical PEEK cage seems to be a good way that does not require additional anterior plating and bone graft harvesting/or achieving cervical interbody replacement. Anterior cervical discectomy and interbody fusion is an effective treatment for radicular pain in selected patients with cervical disc disease after six months follow up. Because of similar clinical outcomes and lack of donor site morbidity when using PEEK, we now prefer fusion with PEEK cage to autologous iliac crest graft

Harmonic scalpel tonsillectomy versus bipolar electrocautery and cold dissection

The aim of this study is to compare total tonsillectomy by harmonic scalpel [TTH] with bipolar Electrocautary [TTE] and cold dissection in children with chronic tonsillar hypertrophy. Patients were selected from Dar Al Shifa hospital, Kuwait, complaining of recurrent attacks of acute tonsillitis with possible snoring and obstructive sleep apnea. Twenty children with chronic tonsillitis who underwent harmonic scalpel tonsillectomy [TTH] were compared with twenty children who underwent tonsillectomy with bipolar Electrocautary [TTE] and twenty children with cold dissection from January to December of 2008. The main parameters included: Surgical time, estimated blood loss, Postoperative pain, hospital stay and postoperative complications. 60 children were evaluated in this study, 42 [70%] males and 18 [30%] females. TTH group had shorter operating time [[mean: 7.1 mm], than the TTE group [mean 7.7 min] or the cold dissection group [mean 11.3 mm]. intra-operative bleeding is significantly reduced in TTH group [mean 6.3ml] than TTE group [mean 8.3 ml] or the cold dissection group [mean 10, 7 ml]. postoperative pain score reduced in the TTH group [1st day: mean 3.6 and 1st week: mean 2.4] than the TTE group [1st day: mean 4.7 and 1st week: mean 2.9] or the cold dissection group [1st day: mean 4.1 and 1st week: mean 2.6]. Postoperative bleeding reduced in the TTH group [0%], than the TTE group [10%] or the cold dissection group [5%].Use of the Harmonic scalpel for tonsillectomy may have several advantages over standard methods like electrocautery or cold dissection. lntraoperative blood loss and episodes of postoperative hemorrhages have been found to be minimal in patients in whom the harmonic scalpel was used for tonsillectomy. The device also appears to be associated with a reduction in operating time and postoperative pain

Relaesable scleral flap suture in trabeculectomy: preliminary results of a new technique

To demonstrate a technique for a releasable scleral flap suture placed to reduce post-trabeculectomy complications. Under a fornix based conjunctival flap, a rectangular partial thickness scieral flap is fashioned. A scierostomy is made followed by a peripheral iridectomy and the scieral flap is secured. A trapezoid suture is then placed from the sciera across the scleral flap to exit on the corneal surface and then tightend under the conjunctival flap which is then secured. During the follow-up, this suture can be safely removed on the slit lamp if the lOP is high. If the lOP is ideal, the suture can be left in place. Immediate postoperative complications as flat anterior chamber and choroidal detachment didn't occur. The suture was removed only if the filtration was not sufficient and the lOP was high. The releasable scieral flap suture was effective in preventing post trabeculectomy complications. In addition, it can be easily removed on the slit lamp without the need to fish under the conjunctiva, or to search for equipments as lasers

Admission cardiotocography test: effect on neonatal outcome and obstetric intervention

The aim of this study is to compare the effect of admission cardiotocography [CTG] and Doppler auscultation of the fetal heart [FH] on neonatal outcome and obstetric intervention in a low risk obstetric population. It prospectively analysed 299 pregnant women who had no obstetric complications that warranted continuous monitoring of fetal heart rate [FHR] in labour. Women were given the choice either to receive CTG for 20 minutes or Doppler auscultation of the fetal heart when they were admitted in spontaneous uncomplicated labour. The outcome measures were umbilical arterial metabolic acidosis, other measures of neonatal condition at birth and obstetric intervention. There were no significant differences in the incidence of metabolic acidosis or any other measure of neonatal outcome among women who remained at low risk when they were admitted in labour. However, compared with women who received Doppler auscultation, women who had admission CTG were significantly more likely to have continuous FHR monitoring in labour, epidural analgesia, augmentation of labour, instrumental delivery and Caesarean section. Compared with Doppler auscultation of the FH, admission CTG does not benefit neonatal outcome in low risk women, and its use results in increased obstetric intervention

Aberration profile of the Alcon[R] Acrysof[R] Acrylic intraocular lenses: in vivo assessment

To evaluate the aberration profile of patients implanted with the Alcon[R] Acrysof[R] Acrylic intraocular lenses [IOLs]. Dar El-Oyoun specialized eye hospital, Cairo, Egypt. Twenty cataractous eyes that underwent phacoemulsification and implantation of Alcon[R] Acrysof[R] MA60BM IOL. One month after surgery, all patients had an aberration profile study using the VISX[R] wavescan system, more attention being paid to the higher order aberrations. Patients showed predominance of higher order spherical aberrations [100%], comalike aberrations [60%] and trefoil aberrations [40%]. Modifications should be made to IOL designs to minimize such aberrations aiming to obtain super vision

Gallstone disease in a rural Bangladeshi community.

BACKGROUND: The prevalence of gallstone disease (GSD) in Bangladesh is not known. We evaluated the prevalence of GSD and its relation with certain factors in a rural community in Bangladesh. METHODS: A total of 1332 persons aged 15 years and above from two villages were invited to participate in the study; 1,058 (80%) subjects responded after three invitations. Each subject answered a questionnaire, including demographic features, and underwent an upper abdominal ultrasound examination. RESULTS: GSD (current cholelithiasis and history of cholecystectomy) was detected in 5.4% of subjects. The prevalence was higher in women (7.7%) than in men (3.3%; p=0.002) The prevalence rates increased from 0.9% to 10% (p=0.0124) from those aged <30 years to those >50 years. A larger proportion of obese subjects (25/52; 48.1%) had GSD than non-obese subjects (32/1006; 3.2%). Prevalence in low, middle and high socio-economic classes was 1.5%, 5.7% and 13.4%, respectively (p=0.000). A majority (71.9%) of subjects with GSD were asymptomatic. CONCLUSION: Approximately 5% of the Bangladeshi rural community evaluated have GSD. Higher age, female gender, presence of obesity and higher socio-economic class were associated with higher prevalence of GSD.