Timing of Surgery and Pre-operative Physiological Parameters as Clinical Predictors of Surgical Outcomes in Traumatic Subaxial Cervical Spine Fractures and Dislocations / Momento da cirurgia e parâmetros fisiológicos pré-operatórios como fatores preditivos clínicos de desfechos cirúrgicos em fraturas e luxações traumáticas subaxiais da coluna cervical

Abstract Objective To evaluate the risk factors and outcomes in patients surgically treated for subaxial cervical spine injuries with respect of the timing of surgery and preoperative physiological parameters of the patient. Methods 26 patients with sub-axial cervical spine fractures and dislocations were enrolled. Demographic data of patients, appropriate radiological investigation, and physiological parameters like respiratory rate, blood pressure, heart rate, PaO2 and ASIA impairment scale were documented. They were divided pre-operatively into 2 groups. Group U with patients having abnormal physiological parameters and Group S including patients having physiological parameters within normal range. They were further subdivided into early and late groups according to the timing of surgery as Uearly, Ulate, Searly and Slate. All the patients were called for follow-up at 1, 6 and 12 months. Results 56 percent of patients in Group S had neurological improvement by one ASIA grade and a good outcome irrespective of the timing of surgery. Patients in Group U having unstable physiological parameters and undergoing early surgical intervention had poor outcomes. Conclusion This study concludes that early surgical intervention in physiologically unstable patients had a strong association as a risk factor in the final outcome of the patients in terms of mortality and morbidity. Also, no positive association of improvement in physiologically stable patients with respect to the timing of surgery could be established.

Resumo Objetivo Avaliar os fatores de risco e os desfechos em indivíduos submetidos ao tratamento cirúrgico de lesões subaxiais da coluna cervical em relação ao momento da cirurgia e aos parâmetros fisiológicos pré-operatórios dos pacientes. Métodos O estudo incluiu 26 pacientes com fraturas e luxações subaxiais da coluna cervical. Dados demográficos, investigação radiológica apropriada e parâmetros fisiológicos, como frequência respiratória, pressão arterial, frequência cardíaca, pressão parcial de oxigênio (PaO2) e escalas de disfunção da American Spine Injury Association (ASIA), foram documentados. No período pré-operatório, os pacientes foram divididos em dois grupos. O grupo instável (I) continha pacientes com parâmetros fisiológicos anormais e o grupo estável (E) era composto por pacientes com parâmetros fisiológicos dentro da faixa de normalidade. Os pacientes foram ainda subdivididos em grupos de tratamento precoce e tardio de acordo com o momento da cirurgia como Iprecoce, Itardio, Eprecoce e Etardio. Todos os pacientes foram chamados para consultas de acompanhamento em 1, 6 e 12 meses. Resultados Cinquenta e seis por cento dos pacientes do grupo E apresentaram melhora neurológica em um grau ASIA e desfecho bom independentemente do momento da cirurgia. Os desfechos em pacientes do grupo I com parâmetros fisiológicos instáveis e submetidos à intervenção cirúrgica precoce foram maus. Conclusão Este estudo conclui que a intervenção cirúrgica precoce em pacientes com instabilidade fisiológica teve forte associação como fator de risco no desfecho final em termos de mortalidade e morbidade. Além disso, não foi possível estabelecer nenhuma associação positiva de melhora em pacientes com estabilidade fisiológica em relação ao momento da cirurgia.

A Clinical Study To Determine The Role Of Guda Haritaki And Punarnava Mandura In The Management Of Pandu Roga W.s.r. To Iron Deficiency Anaemia Among Children

Nutritional anaemia is frequently observed in India. Prevalence of anaemia in Indian children is 59% (Hb<11gm/dl) but it’s higher among rural children. Iron deficiency is most common type nutritional deficiency anaemia in children. The nearest correlation of iron deficiency anemia (IDA) can be made with Pandu Roga in Ayurveda. The side effects of oral allopathic iron preparations are very common, therefore to get a better alternative, two Ayurvedic medicines, the Guda Haritaki and Punarnava Mandura, were subjected to a clinical trial among children suffering from IDA. Aim: Determine the role of Guda Haritaki and Punarnava Mandura in the management of Pandu roga w.s.r. to iron deficiency anaemia among children. Materials and Methods: The study was conducted on 35 children of IDA for a period of 6 weeks. Clinical features (Panduta, Daurbalya etc.) and hematological parameters (Hb gm %, sr. ferritin etc.) were documented before, during and after treatment. Statistical Analysis Used: Observations of the study were analyzed and findings were evaluated by using statistical methods Results: In the present study 58.82% improvement in Panduta was observed with Guda haritaki, 65% with Punarnava Mandura and 67 % when both drugs were given together. No adverse effect of the trial drug was observed during the study. Conclusions: The results suggest that Punarnava mandura along with Guda Haritaki is more effective in comparison to single use of either formulation in the management of IDA in children.

To To Study The Prevalence And Risk Factors Of Pandu Roga Vis-à-vis Anaemia Among School Going Children

Background: The prevalence of anaemia in general and iron deficiency anaemia in particular is presently rising in the society. The primary objective of this study was to determine the prevalence of anaemia among school going children in rural and semi urban areas of Kangra district (Himachal Pradesh). Secondary objective was to identify the etiological and contributory factors in anaemia on the basis of Ayurvedic fundamentals. Methods: A population of 200 children studying in different schools of rural and semi urban areas of Kangra district Himachal Pradesh and IPD as well as OPD of department of Kaumarbhritya, R.G.G. P.G. Ayurvedic college and hospital Paprola were included in the survey. The data obtained from the survey was evaluated to assess the prevalence of anemia and its correlates. To fulfill the aims and objectives a specially prepared performa was designed and all details of the children were recorded in it. Results: The prevalence of anaemia was found to be 69% in school going children in rural areas of Kangra district, Himachal Pradesh. The major risk factors which were observed in present study were nutrition, socio-economic status, pica and dewormification. Conclusion: Anaemia is comparatively more common among children of semi urban and rural areas of Himachal Pradesh possible due to multiple factors like low socioeconomic status, menstruation and inadequate diet etc.