ABSTRACT
Background Bendopnea is a symptom mediated by increased ventricular filling pressure during bending forward. Presence of bendopnea in patients can be easily evaluated without additional maneuver in several countries whose norms, habits, culture, and occupation relates to a higher frequency of bending forward. This information may prove valuable in routine clinical practice. We aimed to analyze the latest evidence on bendopnea in order to further define the clinical significance of this symptom. Methods We performed a comprehensive search on bendopnea in heart failure from inception up until January 2019 through PubMed, EuropePMC, EBSCOhost, Cochrane Central Database, and ClinicalTrials.gov. Results There were 283 patients (31.76%) who have bendopnea, and a total of 891 patients from six studies were included. Bendopnea was associated with the presence of dyspnea [odds ratio (OR) 69.70 (17.35–280.07); <0.001], orthopnea [OR 3.02 (2.02–4.52); <0.001], paroxysmal nocturnal dyspnea [OR 2.76 (1.76–4.32); <0.001], and abdominal fullness [OR 7.50 (4.15–13.58); <0.001]. Association with elevated jugular venous pressure was shown in two studies. New York Heart Association (NYHA) functional class IV was more prevalent in patients with bendopnea [OR 7.58 (4.35–13.22); <0.001]. Bendopnea was also associated with increased mortality [OR 2.21 (1.34–3.66); 0.002]. Conclusion Bendopnea is associated with the presence of several signs and symptoms. This study also showed that bendopnea is one of the signs and symptoms of advanced heart failure associated with increased mortality. However, owing to the limited number of studies, further investigation is needed before drawing a definite conclusion.
ABSTRACT
Objective: The objective of the study was to assess the effectiveness of laminoplasty in terms of improvement in the Japanese Orthopedics Association [JOA] score in cervical spondylotic myelopathy [CSM]
Study Design: Descriptive study
Place and Duration of Study: Department of Neurosurgery, Lahore General Hospital, Lahore, from June 2014 to October 2016
Methodology: All patients having CSM were assessed preoperatively and postoperatively by JOA score and radiological findings. Preoperative X-rays of cervical spine were done to rule out kyphotic deformity. CT scan and MRI of cervical spine were obtained preoperatively to assess the pathology. Single-door laminoplasty with modified trauma plates were applied in each case by making the hinge over the right side. Digital cervical spine X-rays and CT scans with axial reconstruction were obtained postoperatively in all patients, ensuring spinal canal widening and stability
Results: Among the 36 patients, 24 were males and 12 females, age ranging from 35 to 80 years. All the patients did extremely well with marked improvement in the symptomatology. The JOA scored improved in 32 patients, remained static in three patients and one patient had slight deterioration, which later on improved. Three patients developed postoperative kyphotic deformity, which settled in three months. Postoperative radiology showed significant increase in the axial diameter of spine
Conclusion: Cervical laminoplasty remains an effective method for posterior decompression of spine. The most promising approach to cervical myelopathy ought to take into account both the features of patients and disease, as well as the competency and skills of the surgeon
ABSTRACT
The study group comprised of 16 jaundiced children [mean age 3.16 months] with bilirubin levels of more than 8mg/dl. The clinical differential diagnosis included biliary atresia versus neonatal hepatitis. Informed consent was taken from all the parents. Parents were advised to omit the morning feed. All children were pretreated with phenobarbitone [5mg/ kg/day for 5 days] and imaged twice on two different days: first with Tc-99m-DISIDA and dose of 37MBq was injected intravenously. Liver images were obtained at 1, 2, 3 and 24 hours following injection. Then injection of Tc-99m-MIBI with a dose of 37MBq was injected intravenously. Anterior abdominal images with 350k counts were obtained at 10, 20, 30 and 40 minutes post injection and where appropriate delayed additional views were taken to optimize radionuclide intestinal transit. Two nuclear medicine physicians visually analyzed the scintigrams. On the basis of biliary-enteric kinetics the patients were subdivided into sub-groups: Group 1: Included 12 patients with no bowel activity with DISIDA scan but demonstrable bowel activity with MIBI liver scan with the appearance of central or peripheral abdominal activity. Group 2: Consisted of 4 patients with no bowel activity with both DISIDA and MIBI liver scans. Of the 4 patients 2 had biliary atresia confirmed at laparotomy whilst 2 children were lost to follow-up since the children had traveled from remote parts of the country