ABSTRACT
BACKGROUND: The two most common types of surgically treated lumbar spondylolisthesis in adults include the degenerative and isthmic types. The aim of this study was to compare the functional outcomes of surgical decompression and posterolateral instrumented fusion in patients with lumbar degenerative and isthmic spondylolisthesis. METHODS: In this retrospective study, we reviewed the clinical outcomes in surgically treated patients with single level, low grade lumbar degenerative, and isthmic spondylolisthesis (groups A and B, respectively) from August 2007 to April 2011. We tried to compare paired settings with similar initial conditions. Group A included 52 patients with a mean age of 49.2 +/- 6.1 years, and group B included 52 patients with a mean age of 47.3 +/- 7.4 years. Minimum follow-up was 24 months. The surgical procedure comprised neural decompression and posterolateral instrumented fusion. Pain and disability were assessed by a visual analog scale (VAS) and the Oswestry Disability Index (ODI), respectively. The Wilcoxon and Mann-Whitney U-tests were used to compare indices. RESULTS: The most common sites for degenerative and isthmic spondylolisthesis were at the L4-L5 (88.5%) and L5-S1 (84.6%) levels, respectively. Surgery in both groups significantly improved VAS and ODI scores. The efficacy of surgery based on subjective satisfaction rate and pain and disability improvement was similar in the degenerative and isthmic groups. Notable complications were also comparable in both groups. CONCLUSIONS: Neural decompression and posterolateral instrumented fusion significantly improved pain and disability in patients with degenerative and isthmic spondylolisthesis. The efficacy of surgery for overall subjective satisfaction rate and pain and disability improvement was similar in both groups.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Decompression, Surgical , Lumbar Vertebrae/surgery , Recovery of Function , Spinal Fusion , Spondylolisthesis/diagnosis , Treatment OutcomeABSTRACT
Objectives: Chronic diarrhea is a major problem worldwide with high morbidity and mortality. Study design: it is a retrospective study. The medical records of the patients with chronic diarrhea who were subjected to endoscopic evaluation were revised. The study was conducted on patients who attended the pediatric Gastroenterology and Endoscopy unit of Alex and ria Children's University Hospital along two years from January 2012 to December 2013. Methodology: The medical records were revised for: history, clinical examination, laboratory investigation and endoscopic findings. Results: forty patients were included in this study. The age range of the patients was from three months to eleven years. Patients from rural areas more than from urban regions, sixty five percent of the patients were males. Mucoid diarrhea was the most common type of diarrhea. Failure to thrive was evident in abetalipoproteinemiaandinflammatory bowel disease. Fecal calprotectin above 150mg/kg is highly specific and sensitive f or inflammatory bowel disease. Esinophilic enteroclolitis was the most common disease [57.5%] followed by celiac disease [15%] then ulcerative colitis [12.5%]. Conclusion: Management of patients with chronic diarrhea should be initiated and followed in a specialized Pediatric GIT unit since it requires experience and close clinical endoscopic and pathological assessment.
ABSTRACT
Objectives: Chronic diarrhea is a major problem worldwide with high morbidity and mortality. Study design: it is a retrospective study. The medical records of the patients with chronic diarrhea who were subjected to endoscopic evaluation were revised. The study was conducted on patients who attended the pediatric Gastroenterology and Endoscopy unit of Alex and ria Children's University Hospital along two years from January 2012 to December 2013. Methodology: The medical records were revised for: history, clinical examination, laboratory investigation and endoscopic findings. Results: forty patients were included in this study. The age range of the patients was from three months to eleven years. Patients from rural areas more than from urban regions, sixty five percent of the patients were males. Mucoid diarrhea was the most common type of diarrhea. Failure to thrive was evident in abetalipoproteinemiaandinflammatory bowel disease. Fecal calprotectin above 150 mg/kg is highly specific and sensitive for inflammatory bowel disease. Esinophilic enteroclolitis was the most common disease [57.5%] followed by celiac disease [15%] then ulcerative colitis [12.5%]. Conclusion: Management of patients with chronic diarrhea should be initiated and followed in a specialized Pediatric GIT unit since it requires experience and close clinical endoscopic and pathological assessment.
ABSTRACT
To evaluate the risk of malignancy index [RMI] for pre-operative diagnosis of ovarian mass. Design: Observational study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology at Armed Forces Institute of Pathology [AFIP], Rawalpindi from January 2001 to January 2002. Subjects and The study consisted of 100 female patients consecutively admitted for surgical exploration of ovarian mass. Pre-operatively ultrasonic evaluation of ovarian mass, menopausal status and serum cancer-associated antigen 125 [CA 125] levels were carried out. Postoperatively histopathology of the resected ovarian mass was done to confirm the diagnosis. To increase the sensitivity and specificity of CA 125 for early detection of ovarian cancer, a combination of serum CA 125 with ultrasonography and menopausal status, designated as risk of malignancy index [RMI] for each patient, was calculated. The sensitivity and specificity of CA 125 alone for the diagnosis of ovarian cancer, at cutoff level of 35 U/ml, were 83% and 82% respectively. Using RMI, at cutoff level of 125, the sensitivity was 87%, and specificity was 88%. Receiver operating characteristic [ROC] curves reveal that RMI was a better discriminant than CA 125 alone for differentiating between benign lesions and malignant ovarian tumors. The risk of malignancy index [RMI] is a better diagnostic marker as compared to CA 125 alone because of its high specificity and sensitivity in differentiating ovarian cancer from ovarian benign lesions. It is a simple scoring system and, therefore, its application is recommended to evaluate ovarian masses in clinical practice