Objective: Purpose of conducting this study was to evaluate the surgical outcome of open carpal tunnel release using Global Symptom Severity score (GSS) in our local setting. Material and Methods: This prospective analytical study was conducted in the Neurosurgery Department Hayatabad Medical Complex, Peshawar. We operated consecutive 105 Carpal tunnel syndrome cases over a period of 2 years via open carpal tunnel release (OCTR) method. All of these cases were surgically indicated. All patients were evaluated preoperatively with clinical assessment and NCS. Cases were operated under local anesthesia as a day case surgery. Patients were evaluated at 3 months follow-up visit using global symptom severity score (GSS) and compared with pre operative GSS. The paired sample test was applied to obtain p value. Results: Total 105 patients were operated during study period. 72 (69%) patients were women and 33 (31%) were men. The mean age of patients was 41 years. 70 (66.66%) procedures were done for the right hand and 35 (33.33%) were performed for left hand. Pre-op Mean GSS score was 27 ± 2.5 which decreased to 2.1 ± 0.43 postoperatively (P < 0.005). Conclusion: Carpal tunnel syndrome is more commonly affecting the dominant hand of middle aged females. Open carpal tunnel release procedure is the safe and effective treatment for this compressive neuropathy.
Objective: The aim of conducting this study was to evaluate the outcome of a Micro vascular Decompression procedure for the definitive treatment of Trigeminal Neuralgia in our setup. Material and Methods: This observational prospective study was carried out in Neurosurgery unit Hayatabad Medical Complex, Peshawar. A total of 50 patients operated for micro vascular decompression surgeries were enrolled in the study, both genders and any age were in inclusion criteria. Patients previously operated for trigeminal neuralgia were excluded from the study. Post operatively all patients were followed for 1year to calculate the outcome in terms of pain control using visual analogue score (VAS). Immediate pain relief during the first post-operative week and trigeminal neuralgia pain at 1 year post op were recorded and graded into three categories based on Visual Analogue Scale (VAS) such as Excellent: 0-2 , Good: 3-6, Fail/Poor: 7 – 10. Results: 50 patients fulfilled the inclusion criteria. 22 were male & 28 were female with an age range from 42-78 years. Average duration of disease was 5 years. In 30 patients, clinically v2-v3 were predominantly involved, in remaining 14 patient v1-v2 were involved & only in 6 patients all three branches were involved. Among all operated 50 patients 18(36%) had excellent pain relief, 26 (52%) had good pain relief & 6 (12%) had fail/poor pain relief. Conclusion: From this data it was concluded that micro vascular decompression is an effective surgical procedure in relieving pain of trigeminal neuralgia in patients who are refractive to medical treatment.
Background: Pediatric forearm fractures result in substantial morbidity andcosts. Despite the success of public health efforts in the prevention of other injuries, the incidenceof pediatric forearm fractures is increasing. Most forearm fractures occurred during the springseason. Objective of the study is to determine the functional outcome of conservatively treatedradius ulna fractures in Children. Design: Descriptive study. Setting: Department of Orthopedicsand Traumatology, Khyber Teaching Hospital Peshawar. Period: March 2009 to April 2010.Methodology: Total 236 children with radius ulna fractures were manipulated and above elbowplaster Cast applied for 6-8 weeks and reviewed every second week. After plaster cast removalPronation and supination measured with goniometer and fortnightly thereafter for 6 weeks.Results: All the fractures united. Normal range of pronation and supination at the end of followsup period was in 182(80.53%) children. Loss of pronation and supination of average 10 degreeswere in 9(3.98%) patients. Patients having displacement of the fracture and opted for surgerywere 35(15.46%). Conclusions: Closed reduction of diaphyseal fractures in children results innormal pronation and Supination in majority of the patients.
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