Central cord syndrome is an incomplete spinal cord injury first described by Schneider et al. (J Neurosurg 11:546-547, 1954). The typical neurological deficit is symmetrical incomplete quadriplegia affecting the upper more than the lower limbs; sensory impairment is variable and urinary retention is common. Records of all patients with acute traumatic central cord syndrome admitted to the National Spinal Injuries Unit from 1999 to 2007 were compiled from a prospectively collected computerized spinal database. Data recorded included patient demographic profile, mechanism of injury, initial neurological deficit, treatment instituted, complications of treatment, and final neurological status. A total of 50 patients with acute traumatic central cord syndrome were identified accounting for 6.2% of all admissions to the spinal injuries unit. There were 42 men and 8 women. The mean age was 56.1 years with a range of 41-88 years. We stratified patients according to age at injury to determine the effect of age on clinical outcome. There were 13 patients \50 years of age, 24 aged 50-70, and 13 aged [70 years. The mean follow-up time was 42.2 months. More than onethird of patients were intoxicated with alcohol at the time of the injury. Both upper and lower limb motor scores and total sensory scores improved in all age groups. Absolute and relative improvements were greatest in patients \50 years of age. Sphincter disturbance was documented in 42% of all the patients on admission. At follow up 12% of patients had residual disturbance. At final follow up none of the patients under 70 years of age had residual sphincter disturbance while 60% of those aged [70 years group had. Both of these results reached statistical significance. In conclusion, central cord syndrome is a common cause of acute traumatic neurological deficit, with alcohol intoxication being a common confounder at the time of injury. The clinical outcomes are significantly worse in patients aged 70 years or older.
Objective:
The objective of this study was to assess the attitude and hesitancy towards vaccine against COVID-19 in a Pakistani Population.
Materials and Methods:
A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate..The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15
th
September to 30
th
November 2020.
Results:
The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62±10.47 years. The majority of participants were females; 60.9% (n=611). 57.02% (n=572) of the participants were employed at the time of survey. Overall, 70.68% (n=709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n=49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n=392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P<0.001).
Conclusion:
This study demonstrated that majority of the participants showed positive attitude towards considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population towards COVID-19 vaccination.
Slipped capital femoral epiphysis (SCFE) is a disorder of adolescent age. Presentation of SCFE earlier than the expected age range should prompt the clinician to consider the presence of an underlying endocrinopathy. Early recognition and aggressive management of the predisposing endocrine disorder is crucial to prevent treatment failure and associated morbidity. We report the clinical presentation and treatment of an 8-year-old girl with bilateral slipped capital femoral epiphysis. The unusual age, persistent hypocalcemia, and associated distal femoral physeal deformities prompted further evaluations, which led to the diagnosis of pseudohypoparathyroidism type 1b. PHP type 1b is an extremely rare cause of SCFE and only a few cases have been reported. A delay in diagnosis in such case is not uncommon.
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