RESUMO
Objective: It is well recognized that incidence of thyroid disease is increasing in Saudi Arabia and varies in geographical areas of Saudi Arabia. This study was aiming to evaluate the patterns of thyroid pathology in Al Kharj region, which is a rural agricultural area in central Saudi Arabia with relatively large [3.1%] population
Methods: The retrospective study was designed covering period from 2012 to 2016, which include only patients, who received surgical treatment for the various thyroid pathologies. All data was collected from Department of Surgery at King Khaled Hospital [KKH], which is the university hospital, serving over 600,000 population of Al Kharj region. 92 thyroidectomies performed for various thyroid disorders where analyzed
Result: The incidence of thyroid disease for females in Al Kharj region was estimated as 2.7/100.000 of population per year comparing to males of 0.4/100.000 respectively. Female to male ratio of 6.7:1 was observed in relation to the overall thyroid pathologies. The mean age of all studied cases was 41.3 years ranging from 19 to 77 years. The majority of the thyroid diseases was in the age group 20-50 years [79.3%]. Cancerous lesions were found in 35 cases [38%] and presented mainly as papillary or follicular carcinomas with the female to male ratio of 10.5:1. The prevalence of thyroid cancer in Al Kharj region in current study was 1.1/100.000 of population per year for females and 0.1/ 100.000 of population per year for males respectively
Conclusion: This study showed that in central rural province of Saudi Arabia females are dominantly affected by thyroid pathologies. The female to male ratio requiring surgical intervention was higher in Al Kharj region compared to the other Saudi Arabian areas. Incidence of thyroid pathology and prevalence for thyroid cancer was significantly higher in females compare to male population
RESUMO
Background: Anterior Cruciate Ligament [ACL] reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program
Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews
Methods: a Systematic search in the scientific database [Medline, Scopus, EMBASE , and Google Scholer] between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint [ ACL reconstruction rehabilitation ] studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed
Results: the search results yielded five studies which evaluated eight rehabilitation components [bracing, Continuous passive motion [CPM], neuromuscular electrical stimulation [NMES], open kinetic chain [OKC] versus closed kinetic chain [CKC] exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation]. A strong evidence suggested no added benefit of short term bracing [0-6 weeks post-surgery] compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction
Conclusion: short term post-operative bracing and continuous passive motion [CPM] introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1] CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term [6-14 weeks] after ACL reconstruction and 2] home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear