Introduction: The surgical procedure by the anterior, posterior and combined antero-posterior approaches had applied for the treatment of cervical spondylotic myelopathy. Methods: During the treatment process, all patients were pre-operatively as well post-operatively graded according to Japanese Orthopaedics Association. Several surgical methods such as anterior approach, posterior approach, and combined antero-posterior approach have been addressed for CSM patients, with the choice based on the pathogenesis of the myelopathy. The main indications for surgery were evidence of myelopathy on physical examinations, a JOA score below 13 points help with spinal cord compression observed on plain X-ray, CT scan, MRI studies. Results: The pre-operative JOA scores were 7.60±1.23 in laminoplasty, 8.30±1.03 in diskectomy and corpectomy and 7.10±1.20 in combined antero-posterior approach patients. At the follow-up after three months the JOA scores were laminoplasty 13.30±1.30, diskectomy and corpectomy 13.55±1.15 and combined antero-posterior 13.50±1.08. The JOA recovery rate averaged, 61.08±11.25% in laminoplasty, 60.67±10.60% in diskectomy and corpectomy and 64.67±10.72% in combined anteroposterior approach. The high- signal intensity changed to normal in 18 out of 28 and no any kyphotic change and instability were found in cervical spine at the follow up. Conclusions: Patients with OPLL (continuous, segmental and mixed type), stenosis of cervical spinal canal, multilevel cervical spondylosis, large and high ossification of IVDP with stenosis were improved with laminoplasty. Patients with PIVD, CSM with kyphosis, post laminectomy , OPLL herniated type, unstable vertebral alignment, stenosis by osteophytes, were improved with anterior approach . Ossified or deformed OPLL, unstable vertebral with stenosis ,OPLL or OYL with cervical meandearing (swan-neck) were improved with Combined anterior and posterior approach. Keywords: cervical spondylotic mylopathy, anterior cervical diskectomy and fusion, corpectomy.
Not available.Key words: Mallakal; Mudra; NepalTribhuvan University Journal Vol XXI, No. 2, 1998 Page: 141-146 Uploaded date: 29 April, 2011
Background: The chronic and progressive nature of Diabetes Mellitus often leads people to use complementary and alternative medicines (CAMs) which may be defined as a group of medical and health care systems, practices and products that are not considered to be part of conventional medicine. Methods: This descriptive cross-sectional study was done in a tertiary care hospital in Eastern Nepal from 15th June 2018 to 15th September 2019 to determine proportion of type 2 diabetic patients who have tried complementary and alternative medicines (CAMs) exclusively prior to presentation to endocrine OPD (Outpatient department). Consecutive sampling was done after informed verbal consent. Results: Out of 401 participants, 60.6 percent were male and 39.4 percent were female. Mean age of participants was 52.21 ± 11.42 years. Regarding use of CAMs, 11 percent sad tried some form of CAMs exclusively without any allopathic antidiabetic medicines for some period in their lifetime prior to presentation to endocrine OPD. More specifically, 10.3 percent had tried products under brand of ayurvedic medicines from local practitioners. Similarly, 0.2 percent had tried medicine from Homeopathic Practitioner and rest (0.5 percent) had tried homemade herbal remedies like garlic, fenugreek, aloe vera and bitter melon. Conclusion: A significant proportion of type 2 diabetics in our community are still using CAMs. The associated factors behind this and long term effects of such products in diabetic patients need to be explored further in details.
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