Objective: To evaluate the surgical treatment of tethered cord syndrome (TCS), a prospective analysis of 43 patients operated at Neurosurgery Department Zagazig University hospitals from May 2013 to January 2017 with 1 year follow-up had been done. Patients and methods: Adult and children patients with tethered cord syndrome subjected to microscopic surgeries for release of cord and nerves tethering with exclusion of primary repair of meningiomyelocele, paraplegic patients, hydrocephalic patients, and ages below 2 years old. Magnetic resonance imaging (MRI) of the spine was done for all patients and urodynamic studies for patients more than 6 years old preoperative and postoperative after 1 year of surgery. Results: Ten patients were adults > 18 years old and male to female ratio was about 2:1. All patients presented with multiple clinical manifestations which either improved or stable during follow-up after surgery. Controllable complications occurred: cerebrospinal fluid (CSF) leak in 18.6% and wound infection in 4.7%. Urodynamic studies improved in 73% of patients after surgery and children showed significant improvement in all symptoms except back pain than adult patients. Conclusion: Microscopic surgery is of value for patients suffering tethered cord syndrome with low risk of complications.
, and other parameters like temperature, pH, electric conductivity (EC), total hardness(T.H) and total dissolved solid (TDS) in ten hot springs water samples of some parts of Jebel Mara Mountain, Western Sudan. The results of water analysis revealed theaverage values of pH,electrical conductivity, total dissolved solidsand total hardness, 9.46, 428 µS/cm, 667.2 mg/l and 102 mg/l respectively. The pH, TDS and EC variations confirmed light-salty nature of groundwater. It is also apparent from the results that, average concentrations of sodium, potassium, calcium,magnesium, chloride, sulphate,and bicarbonate ionswere 43.6, 16.4, 53.7, 44, 37.5, 26.2, 428.5 mg/l, respectively. Chloride ion concentration ranged from (30 to 46 mg/l), sulphate ion concentration ranged from (10 to 40mg/l) and carbonate concentration measured ranged from (215 to 800 mg/l).The results were found to be above the recommended values given by W.H.O., 1984) and warranty further recommended studies for the best improvement and utilization of springs water.
Background Wellens syndrome complicates acute coronary syndrome and, if unmanaged, can lead to immanent myocardial infarction. This study aimed towards determining the prevalence of Wellens syndrome among acute coronary syndrome patients while focusing on both types and identifying the most associated risk factor, then determining the commonest coronary artery affected in those who fulfilled Wellens syndrome criteria. Methods Implementing a descriptive cross sectional hospital based observational study design at Ahmed Gasim Teaching Hospital for Cardiac Surgery and Renal Transplantation in Khartoum North, Sudan, the study was conducted using a non probability convenience sampling of patients fitting the inclusion criteria. Data was collected using closed ended structured questionnaires. Ethical clearance was obtained from relevant authorities. Data analysis was done using descriptive and comparative data analysis with the aid of the SPSS software. Results A total of 120 patients were included, 70 males and 50 females, majority in their fifth decade. 14 patients had no documented risk factors. 42.5% had STEMI, 34.2% had NSTEMI and 23.3% had unstable angina. Patients fulfilling Wellens syndrome criteria were 18 (15%), 44.4% of them were type A and 55.6 were type B. Specific prevalence among NSTEMI alone was 29.3% and 21.4% among unstable angina alone. Most frequently encountered risk factor among Wellens syndrome patients was Diabetes (50%). Out of 16 Wellens syndrome patients who underwent coronary angiography, 50% had mid LAD involvement, most were of type B; 25% had proximal LAD involvement and 25% had normal coronary angiography. There was significant association between Wellens syndrome and NSTEMI, but no significant association with any specific risk factor. Conclusion Wellens syndrome is not a rare condition although uncommon, it can present even without a specific predisposing risk factor and coronary angiographic variation other than the proximal part of the LAD artery may occur.
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