Prevalence of and risk factors for cranial neuropathy in diabetic and non-diabetic patients.

OBJECTIVE: Diabetes mellitus (DM) is a major global health concern and is associated with high morbidity and mortality as well as poor quality of life. This health burden is mostly due to complications associated with DM. Cranial nerve neuropathy is not a well-studied complication of DM. In this study, we aimed to study the prevalence and risk factors for the development of cranial neuropathy in diabetic patients. PATIENTS AND METHODS: This is a cross-sectional study among diabetics who are attending Almanhal Primary Healthcare Center, Abha, Aseer Province, Saudi Arabia. A total of 714 subjects were included, 238 of them were in the study group and 476 were controls chosen randomly from the same community. SPSS program was used to calculate demographic, clinical, and biochemical parameters as well as to measure the statistically significant differences. Analysis was conducted using the SPSS statistical package and p-value lower than or equal to 0.05 was considered statistically significant. RESULTS: The diabetic patients were significantly older than the control group; the mean standard deviation (SD) age was 59.78 (8.26), and 34.04 (9.45) for both study and control groups, respectively. The prevalence of cranial neuropathy was higher in diabetic patients. Among diabetic patients, hyperlipidemia, gestational DM, compliance with DM treatment, and the presence of microvascular complications of DM are significant risk factors for the development of cranial neuropathy. CONCLUSIONS: Our results indicate that the prevalence of cranial neuropathy is higher in the diabetic population than in the non-diabetic population. The oculomotor and trigeminal nerves were the most commonly affected nerves in diabetic patients compared to the abducent and facial nerves in non-diabetic patients.

Extra-axial hematomas due to road traffic accidents and their outcome: a ten-year study.

OBJECTIVE: The main objectives of this study were to describe the epidemiological characteristics, the associated factors and outcomes of extra-axial hematoma (EAH) in patients of traumatic brain injury (TBI) due to road traffic accident (RTA) and to assess their survival probability after 6 and 12 months to RTA. PATIENTS AND METHODS: This was a retrospective record-based study. A total of 520 patients diagnosed with EAH due to RTA-related TBI were studied. This study covered ten years from January 1, 2010, to December 31, 2019. Descriptive statistics, including frequencies, percentages, mean, standard deviation, median and range were used. To test for significance in the difference between proportions, a chi-square test was applied and adjusted standardized residual to confirm the differences between groups. The Kaplan-Meier curve was plotted, and mean survival rates were calculated for each type of EAH. A two-sided p-value less than 0.05 (5%) at 95% CI was considered to be statistically significant. RESULTS: EAH occurred in 42.1% of RTA-related TBI. Subdural hematoma (SDH) was the most common RTA-related EAH. Age and sex differences exist in the type of EAH with male preponderance and a significantly higher rate of SDH in patients aged 55 years or above. The total EHA mortality was 18.7%, and most occurred within the first month of the incident. Traumatic subarachnoid hemorrhage (tSAH) was associated with poorer outcome in terms of mortality. Epidural hematoma (EDH) has the best prognosis and survival probability at six months and one year from the accident. CONCLUSIONS: Extra-axial hematomas are very common in RTA-related TBIs and have high mortality. SDH is the most common, tSAH had the highest mortality, while EDH has the best survival. Aggressive efforts are compulsory to reduce RTA-related TBI.

Association between orthopedic fractures and traumatic spinal injury due to road traffic accidents.

OBJECTIVE: Traumatic spinal injury (TSI) is a serious trauma-related injury with a significant risk for mortality and morbidity. Road traffic accident (RTA) is the leading cause for the spinal and orthopedic injuries globally. Detailed information on the association of orthopedic fractures with TSI and its influence on outcomes is lacking. In this study, RTA-related TSI with orthopedic associated fractures in terms of demographics, prevalence, patterns, and outcomes were studied. PATIENTS AND METHODS: This was a single-center retrospective study conducted over ten years in the largest tertiary hospital in Southern Saudi Arabia. A total of 184 patients suffered TSI associated with orthopedic fractures out of the 810 RTA-related TSIs (22.71%) were recruited. The majority was males (86%), and 55% of the cohort was between 21-40 years. RESULTS: The commonest spinal injury level was lumbar (25%) followed by the sacral spine (24.5%), while multiple regions orthopedic fractures and fracture pelvis were the commonest orthopedic fractures, 27.2% and 25%, respectively. The mortality rate was 4.3% and significantly correlated with the spinal injury level (p=.018). The region of orthopedic fracture has significant associations with the gender and hospital length of stay (p=.020 and p=.005, respectively). We also found a significant association between the spinal injury level and orthopedic fracture location (p<0001). CONCLUSIONS: Traumatic spinal injuries due to traffic accidents are commonly associated with orthopedic fractures. This association has distinct patterns and influences the patient's outcomes.