Out of 210 patients, 146 were found to have degenerative scoliosis at the level of the lumbar and thoracolumbar spine. Fifty-two patients had a right convex curve, and 94 had a left convex curve. Sixty-nine patients had GERD. According to the analysis of the multivariate logistic regression, the Cobb angle was highly related to GERD (p-value <0.05 and odds ratio of 1.031). The participants were grouped according to the Cobb angle of curve at the lumbar spine (less than 30 degrees with a large right-sided convex curve, 30 and more with a small curve, and more than 30+ degrees with a large left-sided convex curve). The study revealed that a large left-sided convex curve was highly related to GERD, with a p-value <0.05 and odds ratio of 10.935. ConclusionsThe left-sided large convex curve at the thoracolumbar or lumbar spine, especially when the Cobb angle was more than 30 degrees, was highly associated with GERD. Therefore, the symptoms of GERD should be monitored in the elderly population with degenerative scoliosis.
Introduction: Postoperative inguinal pain is one of the most significantcomplications following inguinal hernia repair. Routine ilioinguinal nerve excision has beenproposed as a means to avoid this complication. Objectives: To compare the postoperative painafter preservation and elective division of ilioinguinal nerve during inguinal hernioplasty.Methods: This was a Randomized Controlled Trial conducted at the department of generalsurgery at KVSS Site Hospital for a period of 6 months from Jun 2011 to Nov 2011. 84 patientswho underwent mesh hernioplasty for unilateral inguinal hernia, were randomly assigned into twogroups (A and B), 42 in each group. Ilioinguinal nerve was preserved in group A patients, whereaselective division was carried out in patients of group B. Mean postoperative pain scores wererecorded using numerical analogue scale on first and third postoperative day, and one monthafter surgery. The SPSS version 16 was applied to the data. Results: Mean±SD age was38.46±14.36 years. Seventy four (88.1%) patients were male whereas ten (11.9%) were female,with male to female ratio being 7:1. Using the numerical analogue scale to detect pain severity onpostsurgical day 1 and 3, mean scores±SD in the nerve-preservation and nerve-excision groupswere 2.88±0.43 versus 2.04±0.39, and 1.95±0.39 versus 1.43±0.44, respectively (p<0.05). At 1month after surgery, these scores were 1.73±0.62 versus 0.98±0.25, respectively (p<0.05).Conclusions: Postoperative pain after inguinal hernioplasty significantly decreases in electivedivision of ilioinguinal nerve as compared to nerve preservation.
Amyotrophic lateral sclerosis (ALS) is one of the most common motor neuron diseases (MND), which presents as muscle weakness, atrophy, spasticity, and, in extreme cases, may result in death due to respiratory failure. ALS has been reported with dermatological conditions such as bullous pemphigoid and decreased collagen. Hyperpigmentation usually occurs due to underlying adrenal or metabolic disorder, but no case of hyperpigmentation has been associated with MND. We report a case of a 25-year-old man who presented with signs of young-onset ALS (progressive weakness of both upper limbs) with hyperpigmentation of limbs. The patient did not have any other underlying etiology, which could have led to the development of hyperpigmentation Biopsy was negative for polymyositis and dermatomyositis. The patient was counseled about the nature of the disease and was advised regular follow-ups.
Object: Outcome of wearing high heel shoes in young generation: A CrossSectional Study. Introduction/ Background: High heels increase the heel height, thusincreasing the pressure under the metatarsal head in forefoot, they push the center of mass of thebody forward taking the hips and spine out of alignment moreover the altered posture of walking1-5 in high heels places excessive forces on the inside of the knee joint . All these factors contributein causing deleterious pathologic deformities. The studies carried out previously were morefocused on the adult population furthermore there isn’t much work done to investigate the effectof heels in Pakistan therefore, this was a non-invasive study the purpose of which was to evaluatethese complications particularly targeting the medical students of medical colleges, Karachi.Methods: A total of 220 respondents aged between 15 to 25 years were selected as potentialrespondents meeting the criteria for selection. A convenience based randomized samplingmethod was adopted, where the participants were required to fill questionnaires and give theirdemographic details. They were inquired about the presence of any co morbidities which was anessential part of the exclusion criteria. They were also inquired about their usage of high heelshoes, their size, duration and frequency of usage, and if they had been causing anycomplications such as bunions, heel spur, callosities or pain in soles, calf or back. The dataobtained was analyzed through SPSS and the graphs of frequency for all the complications werecomputed. Results: After analyzing the 220 participants it was found that 7.7% were males while92.3% were females, and 61.8% were found to be within 21 to 23 years of age. After the analysesof data for the complications it was found that out of the total participants 18.8% experience footswelling, 19.4% blisters, 16.4% foot numbness, 12.3% foot callosities, 2.8% heel spur, and 3.7%experience bunions. Conclusions: From this study conducted on the students of medicalcollege it was found that wearing high heel shoes is not associated with any significantcomplications among most of the students
Background: Radiologists are always questioning the use of an imagine modality as compared to the other, this study helps answer that question for the diagnosis of Hepatocellular carcinoma. Objective: To compare the use of MRI imaging technique with ultrasonography for the diagnosis of hepatocellular carcinoma. Study Design: The type of study is a Prospective Cross-Sectional study. Settings: A large tertiary care hospital in Karachi, Pakistan. Duration: One year from July 2018 to July 2019. Methodology: The inclusion criteria was all the patients who were referred to us with symptoms for concern for hepatic tumors. For the MRI we used a 1.5 tesla machine, and for the ultrasound we used a conventional grey scale ultrasonography with a probe of 5 MHz. We performed multiphasic contrast enhanced MRI’s, with images taken both before the injection of the contrast and afterwards in the various phases such as the arterial phase, portal venous phase and finally the delayed phase respectively. Results: The study population consisted of n=110 patients having a mean age of 46.5 +/- 5.50 years. There were n= 78 (70.90%) males and n= 32 (20.09%) females. N= 101 (91.81%) patients had a diagnosis of hepatocellular carcinoma as per MRI scan, for ultrasound n= 47 (42.72%) patients were diagnosed as true positive, n= 2 (1.81%) were false positive, n= 54 (49.09%) were false negative, while n= 7 (6.36%) cases were truly negative. The specificity was 77.77% the sensitivity was 46.53%, the positive predictive value was 95.91%, negative predictive value was 11.4%, and accuracy was 49.09% respectively. Conclusion: We found that the specificity of ultrasound as a diagnostic modality for hepatocellular carcinoma as compared to the MRI scan is good, however it is only able to correctly identify about half the patients, hence care should be taken when interpreting the results of ultrasound for hepatocellular carcinoma.
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