Assessment of nerve conduction study to establish most common electrophysiological predictor of lumbosacral radiculopathy among radiologically diagnosed L5S1 neural foramina compression cases.

Magnetic resonance imaging (MRI) and electromyography (EMG) are complimentary investigations in diagnosis of lumbosacral radiculopathy (LSR). With changing pattern of S1 electrodiagnosis by H-reflex study measures, electrophysiological studies were conducted to establish most common electrophysiological predictors of LSR in MRI diagnosed L5S1 neural foramina compression subjects. Fifty subjects, with definite L5S1 neural foramina compression underwent electrophysiological evaluation and the data was analyzed using established electrodiagnostic criteria. Reduced H/ M ratio in combination with absent H response was evident in 74 nerves. H-reflex study was abnormal in 88% subjects. Study concluded that, H/M ratio if used with other H-reflex study variables may be most common predictor of LSR.

Percutaneous autologous bone marrow injection in the treatment of delayed and non-union of long bones.

Context: Bone marrow has been shown to contain osteo-progenitor cells. Percutaneous autologous bone marrow injection (PABMI) encourages early treatment of delayed union and non-union to expedite healing and minimize complications from prolong immobilization. Aims and objectives: To assess the outcome of PABMI treatment in delayed and non-union of long bones. Study design: Prospective study Participants and procedures: 24 cases (33 bones) of Delayed and non-union of long bones were selected. Percutaneous autologous bone marrow injection treatment was adopted for fracture healing. Change in pattern of union was followed after 12 weeks by clinical and radiological study. Results: 90% of tibial fractures, 66.66% of radial fractures and 50% of ulna fractures show clinical and radiological union. 100% of the fractures with no gap at the fracture site united, where the gap was less than 1 cm, 85% of bone united, in only 1 case the gap was more than 1 cm and it failed to unite. 7 out of 9 bones in hypertrophic non-union united, whereas 4 out of 6 bones in atrophic non-union united. Conclusion: Percutaneous autologous bone marrow grafting is an effective and safe method for the treatment of diaphyseal non union. We strongly believe that an injectable preparation that combines marrow with osteoinductive and osteoconductive agents should virtually eliminate the need for open harvesting and operative grafting of the problems associated with fracture healing.

Prevalence of cardiac autonomic neuropathy in patients with diabetes.

Background: Autonomic neuropathy is a serious complication of diabetes mellitus. Cardiac autonomic neuropathy (CAN) is chronic diabetic complication with variable prevalence and clinical manifestations. Prevalence of CAN remains less explored domain among type 2 diabetic population. Aim: To analyse the prevalence of CAN in type 1 and type 2 DM. Materials and methods: A total of 152 cases with DM were selected for the study following strict inclusion and exclusion criteria. All the cases underwent a battery of cardiovascular reflex tests designed by Ewing. Results: We observed that overall prevalence of CAN was 51.9%. Prevalence of sympathetic and parasympathetic CAN was 28.9% and 44% respectively. When compared, prevalence of CAN in type 1 patients was significantly different from type 2. Further, significant difference was noted between parasympathetic and sympathetic CAN in these patients. Conclusion: Study concludes that, prevalence of CAN in type 1 DM is higher than type 2. Parasympathetic CAN prevalence is higher than sympathetic CAN in both groups.

Auditory evaluation of the microcephalic children with brain stem evoked response audiometry (BERA).

Microcephaly implies a reduced occipito-frontal circumference (< 2 Standard Deviation of normal) and therefore a small brain size, which is usually associated with different neurodeficit. Intactness of the auditory pathway in microcephalic as well as normal children was assessed by Brain stem Evoked Response Audiometry (BERA) to locate the exact site of lesion resulting in the auditory impairment, so that appropriate early rehabilitative measures can be taken. The study revealed that absolute peak latency of wave V, inter peak latencies of III–V and I–V were significantly higher (P- value <0.05 in each case) in microcephalics than the normal children. Auditory impairment in microcephaly is a common neurodeficit that can be authentically assessed by BERA. The hearing impairment in microcephalics is mostly due to insufficiency of central components of auditory pathway at the level of brainstem, function of peripheral structures being almost within normal limit.