RESUMO
Background: Glenohumeral joint is highly susceptible to dislocation due to its wide range of movements. Recurrent anterior shoulder dislocations are common in young adults. The Bristow Latarjet procedure is one of the effective techniques for the treatment of recurrent anterior shoulder dislocation. This study aimed to assess the clinical and functional outcome of the Bristow Latarjet procedure in the management of recurrent anterior shoulder dislocation. Material & Methods: This prospective interventional study was conducted in the Department of Orthopaedic Surgery, BSMMU, from October 2017 to September 2019. Within this period, a total of 40 cases of recurrent anterior shoulder dislocation that meet inclusion criteria were taken as a sample. Patients were evaluated both pre and postoperatively for functional outcomes according to Rowe’s score for instability. A purposive non-randomized sampling technique was used in this study. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Science (SPSS-25). The results were expressed as frequency, percentage and mean ± SD. Paired Student’s‘t’ test was performed to compare pre and final postoperative follow-up. The level of significance was calculated at a confidence interval of 95% and p-value <0.05. Results: : In this study age of the patient ranged from 18-40 years and the mean age was 28.2±6.3. 29(72.5). Surgery was done within 4-6 months of the first dislocation in 5 patients, within 6-12 months in 21 patients and after 12 months in 14 patients. The mean (±SD) Rowe score for instability was significantly (p<0.001) higher 6 months after the Bristow Latarjet procedure at 91.87(±9.00) in comparison to preoperative periods 52.62(±18.40). Results were excellent in 32(80%), good in 4(10%), fair in 3(7.5%) and poor in 1(2.5%) patients. 36(90%) patients were in the satisfactory group and only 4(10%) in the unsatisfactory group. Only 1(2.5%) patient developed screw migration, 2(5%) patients developed subluxation, and 1(2.5%) patient developed postoperative arthritis. Conclusion: It can be concluded that the Bristow-Latarjet procedure is a very effective and safe procedure with reduced complications, presenting very satisfactory functional results in the treatment of recurrent anterior shoulder dislocation.
RESUMO
Background: Obstructive sleep apnea (OSA) is a very common form of sleep disorder with associated health risks. OSA has been accompanied by more insidious conditions, like hypertension, heart disease, diabetes, stroke, and even daytime somnolence. For the diagnosis of sleep disorders, polysomnography is a comprehensive test. It records the patient`s brain waves, the oxygen level in the blood, ‘breathing and heart rate’, and ‘eye and leg movements during the study. Aim of the study: The aim of this study was to assess the effectiveness of polysomnography in the diagnosis of sleep apnea.Material & Methods:This comparative observational study was conducted in the Department of Otolaryngology &, Head Neck Surgery, Bashundara Ad-Din Medical College and Hospital, Bangladesh during the period from July 2020 to June 2021. In total 62 participants were included in the study population for this study. All the participants were divided into two groups. In group A, there were 5 healthy people without obstructive sleep apnea (No OSA group). On the other hand, in group B, there were 57 obstructive sleep apnea patients (OSA group). Ethical approval had been taken from the ethical committee of the mentioned hospital. Data were analyzed by using MS Office and SPSS version 23 programs as per need.Results:In analyzing the sleep scoring between both the groups, in both TRT minutes and total sleep time minutes we did not find any significant correlation (Table: 2). In analyzing the apnea, in comparing mean (±SD) obstructive, total, and AI calculations, we found significant correlations between the groups (Table: 3, Apnea; P values: 0.036, 0.035, and 0.024 respectively. In comparing different parameters of hypopneas (rule 1A), in most of the events, we found significant correlations except mean (±SD) central (Table 3 hypopneas: rule 1A) even, in comparing total mean (±SD) apneas and hypopneas combinedly we found the P-value as 0.002 (Table:3). In the OSA severity comparison between both the groups, in calculating AHI 1 to<15 events/hour, AHI 15 to<30 events/hour, and AHI ?30 events/hour we found significant correlations (P=.001, Table 3: OSA severity). In assessing the Mean (SD) AHI, OAI, RDI (AI+HI+RI), O2 Desats?3% and O2 Desats?3% Index (ODI) we found significant correlations (P values were 0.001, 0.041, 0.001, 0.003, 0.005 respectively). Besides these, in analyzing both the low SpO2 n (%) and snoring: n (%) there was a significant correlation between the group’s patients (P values were .007 and .001 respectively).Conclusion:Polysomnography may be considered an effective method for detecting measuring and treating obstructive sleep apnea (OSA). Sleep scoring and respiratory events analysis plays an important role in assessing the presence and severity of obstructive sleep apnea.