RESUMO
Introduction: Gamma knife surgery is one of the stereotactic surgery which recently used in the treatment of trigeminal neuralgia due to its minimally invasive nature. The short-term effectiveness of gamma knife surgery in a reduction of pain episodes among patients with trigeminal neuralgia are reported by several studies. However, few studies elaborated the long-term effectiveness of gamma knife surgery
Objective: This review aimed at evaluating the effectiveness of gamma knife surgery by reviewing of pain relief rates and recurrence rates reported by the included studies
Methods: The electronic search was conducted in Medline, EmBase and Science direct databases using the key words of [Gamma knife surgery AND trigeminal neuralgia]. The search of the literature, after exclusion of irrelevant, duplicated and review studies revealed 8 studies met the inclusion criteria. The data extraction conducted using data extraction sheet regarding characteristics such as duration of symptoms, number of trigeminal divisions involved, lack of sensation or surgery before surgery, anatomical results in the operation, the rate of pain relief and pain recurrence rate
Results: The history of surgery and medications before gamma knife radio surgery was assessed by included studies. It was found that only one study used gamma knife surgery as their first treatment of choice with no prior surgery. The pain relief rate ranged from 73.8% to 96% while pain recurrence rate, which reported in four included studies ranged from 2% to 26.3%
Conclusions: The gamma knife surgery was not the first surgical choice of treatment in most of the studies. The reported pain relief rates associated with this new technique were generally high while pain recurrence rates were low. As the worst reported scenario found about a quarter of patients complained of pain recurrence following gamma knife surgery
RESUMO
Evaluation of level of consciousness has become essential for anticipation of sepsis and septic shock. Both the Sequential Organ Failure Assessment [SOFA] score and the quick SOFA score utilize the Glasgow Coma Score [GCS] for screening of sepsis
Objectives: the aim of this review is to determine and study the role of Glasgow coma score in anticipation of sepsis and septic shock
Methods: To achieve this aim, we have searched online database, namely PubMed and Cochrane Library for studies and review articles assessing the significance of assessment of Glasgow Coma Scale [GCS] for anticipating sepsis or septic shock. Thirteen appropriatelyrelated studies were selected for review
Results: Disturbed sensorium was found to be a sensitive early indicator for sepsis, thus GCS is used for assessment of both the Sequential Organ Failure Assessment SOFA and quick SOFA scores qSOFA scores. Lower GCS scores were associated with high mortality rates
Discussion: Encephalopathy is an early sign of sepsis and septic shock. Glasgow Coma score GCS was a good indicator of neurological dysfunction evaluated by the SOFA and qSOFA scores. The use of GCS was also a predictor of mortality in patients with sepsis. Some researchers, however, reported that GCS was not the best tool for measuring brain dysfunction in sepsis
Conclusions: Glasgow coma score can anticipate sepsis and septic shock, and predict the outcome of sepsis