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Clinical Charecterstics and Out Come of Patients with Symptomatic Corona Virus Disease 2019 in Small District of Himachal Pradesh in India 印度喜马偕尔邦小区2019年症状性冠状病毒病患者临床特征及预后分析
Pub Date : 2020-10-06 DOI: 10.47009/AJMR.2020.9.3.ME3
S. Chander, A. Thakur, A. Verma, N. Tangri, Rakesh T Chauhan
Background: In India Covid 19 cases started rising after the Lockdown and from January 30 to August 02 there have been 18,07,222 confirmed cases of Covid 19 with 38176 deaths. Now Covid 19 cases are present in small towns and villages as people from major cities has been migrates to their native places. This study describes the demographic, baseline comorbidity, presenting clinical complaints and outcome of the first sequentially patients with COVID -19 in a small district from Himachal Pradesh, In India. Subjects and Methods: This retrospective observational study was conducted in Dr. Radha Krishnan Government medical college, Hamirpur, Himachal Pradesh, India. The inclusion criteria for the study was All symptomatic patients with laboratory-confirmed COVID-19 by Real time polymerase chain reaction (RT-PCR) in Distt. Hamirpur in Himachal Pradesh from March 2020 to 31 July 2020. Oral consent was obtained for the study. The medical records of patients were analysed by the research team of the department of medicine, Dr. Radha Krishnan Government Medical College Hamirpur. Results: Maximum number of patients (92%) migrated from outside the state and majority from the cities of high number of Covid cases. During hospital periods 36% patients had peripheral capillary spo2 less than 95% and required oxygen support. 2(4%) patients died in the hospital and 5(10%) was referred to higher centre. 43(86%) patents recovered and discharged in stable condition. Fever (64%) was the most common symptom followed by cough (60%), fatigue (40), rhinorrhoea (28%), headache (26%) and hypogeusia (16%). Conclusion : The clinical presentation was milder and complications were seen in very few. Special attention is required to the geriatric population and with severe comorbid condition, as they are more likely to have a poor outcome.
背景:在印度,Covid - 19病例在封锁后开始上升,从1月30日到8月2日,已有1807222例Covid - 19确诊病例,38176例死亡。现在,随着大城市人口向家乡迁移,小城镇和村庄也出现了新冠肺炎病例。本研究描述了印度喜马偕尔邦一个小地区首批COVID -19患者的人口统计学、基线合并症、临床主诉和结果。对象和方法:本回顾性观察性研究在印度喜马偕尔邦哈米尔普尔的Radha Krishnan医生政府医学院进行。本研究的入选标准为:本区所有经实时聚合酶链反应(RT-PCR)检测确诊的有症状的COVID-19患者。2020年3月至2020年7月31日在喜马偕尔邦的哈米尔普尔。获得了该研究的口头同意。哈米尔普尔政府医学院Radha Krishnan博士医学系的研究小组分析了患者的医疗记录。结果:州外迁移患者最多(92%),大部分来自病例高发城市。住院期间36%患者外周血毛细血管spo2低于95%,需要吸氧支持。2例(4%)患者在医院死亡,5例(10%)被转诊到更高的中心。43例(86%)痊愈出院,病情稳定。发烧(64%)是最常见的症状,其次是咳嗽(60%)、疲劳(40%)、鼻流(28%)、头痛(26%)和缺氧(16%)。结论:临床表现较轻,并发症少。需要特别注意老年人群和有严重合并症的人群,因为他们更有可能有不良的结果。
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引用次数: 0
Predictors Associated with COVID-19 deaths in Ethiopia 与埃塞俄比亚COVID-19死亡相关的预测因素
Pub Date : 2020-10-06 DOI: 10.47009/AJMR.2020.9.3.MC1
Yenew Alemu Mihret
Background: Coronavirus disease is an infectious disease that causes a newly discovered coronavirus. Ethiopia is one of the most impacted countries relative to the proportion of COVID-19 case growth and infection. The purpose of this investigation was to identify the determinants of COVID-19 disease in Ethiopia. Subjects & Methods: The source of the data for this study was the 2020 Ethiopia health ministry from March up to July using multiple linear regression models. Results: Among 468,814 total tests, 9,027 recovered, 20,900 confirmed cases, and 365 deaths from Coronavirus diseases in Ethiopia. Critical cases (β= 0.570, p= 0.006) and average temperature (β= -35.061, p= 0.003) variables were statistically significant. Conclusion: Critical or serious cases significantly and positively affect the deaths of this pandemic disease, while average temperature significantly and negatively affects the deaths of COVID-19 diseases in Ethiopia.
背景:冠状病毒病是由一种新发现的冠状病毒引起的传染病。就COVID-19病例增长和感染比例而言,埃塞俄比亚是受影响最严重的国家之一。本调查的目的是确定埃塞俄比亚COVID-19疾病的决定因素。研究对象与方法:本研究的数据来源是2020年3月至7月的埃塞俄比亚卫生部,采用多元线性回归模型。结果:在埃塞俄比亚总共进行的468,814次检测中,9027人康复,20,900例确诊病例,365人死于冠状病毒疾病。危重病例(β= 0.570, p= 0.006)和平均温度(β= -35.061, p= 0.003)变量差异均有统计学意义。结论:埃塞俄比亚的危重病例对COVID-19疾病死亡人数有显著的积极影响,而平均气温对COVID-19疾病死亡人数有显著的消极影响。
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引用次数: 1
Correlation of Hepatic Steatosis with Hepatic Fibrosis in NAFLD Patients by Fibroscan NAFLD患者肝脂肪变性与肝纤维化的相关性
Pub Date : 2020-10-06 DOI: 10.47009/AJMR.2020.9.3.ME1
R. Sehgal, Jyotisterna Mittal, I. Singh
Introduction: Nonalcoholic fatty liver disease (NAFLD) is a significant cause of liver injury in the world. Transient elastography with controlled attenuation parameter (CAP) is now days commonly used as a non-invasive modality to quantify liver steatosis and stage of Fibrosis in the Liver. This study was done to the correlation of hepatic Steatosis with hepatic Fibrosis in NAFLD Patients by fibroscan. Subjects and Methods: All NAFLD patients coming to DMCH from 1/1/18 to 30/11/18 were retrospectively analysed for the presence of any correlation between Steatosis and Fibrosis using a controlled attenuation parameter (CAP) and liver stiffness measurement (kPa), respectively by Fibroscan. Patients with a history of significant alcohol intake, viral infection, severe weight loss, on TPN, on drugs like amiodarone, diltiazem, steroids were excluded. Along with this history of hypertension, diabetes and smoking were noted from the available data. Results: The mean CAP of all 446 patients was 310.58  53.55 and the mean kPa was 7.14   4.75. Overall there was a significant correlation between CAP and kPa in all NAFLD patients (p <0.000). This was also true in patients who were more than 20 years of age, who have increased levels of triglycerides and were obese. Patients with S0 steatosis had a mean kPa value of 5.33 and as the steatosis stage worsened to S3 mean kPa value also increased to a maximum of 7.63. Conclusion: Quantification of Steatosis by CAP has a significant correlation with the stage of Fibrosis, especially in patients with increasing age, obese and who have high triglyceride levels.
简介:非酒精性脂肪性肝病(NAFLD)是世界范围内肝损伤的重要原因。瞬时弹性成像控制衰减参数(CAP)是目前常用的一种非侵入性方法来量化肝脂肪变性和肝纤维化分期。本研究通过纤维扫描对NAFLD患者肝脂肪变性与肝纤维化的相关性进行了研究。对象和方法:从1/1/18到30/11/18到DMCH的所有NAFLD患者分别使用纤维扫描控制衰减参数(CAP)和肝脏硬度测量(kPa)回顾性分析脂肪变性和纤维化之间是否存在任何相关性。排除有严重酒精摄入史、病毒感染史、严重体重减轻史、TPN史、胺碘酮史、地尔硫卓史、类固醇史的患者。除了高血压病史外,还有糖尿病和吸烟病史。结果:446例患者CAP平均值为310.58 53.55,kPa平均值为7.14 4.75。总的来说,所有NAFLD患者CAP和kPa之间存在显著相关性(p <0.000)。20岁以上、甘油三酯水平升高、肥胖的患者也是如此。S0期脂肪变性患者的平均kPa值为5.33,随着脂肪变性恶化到S3期,平均kPa值也增加到最大值7.63。结论:CAP定量脂肪变性与纤维化分期有显著相关性,特别是在年龄增长、肥胖和甘油三酯水平高的患者中。
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引用次数: 1
A Comparative Study of Storage Related Haematological Changes in Whole Blood and PRBC in Blood Bank of a Tertiary Care Hospital 某三级医院血库全血与红细胞贮藏相关血液学变化的比较研究
Pub Date : 2020-07-09 DOI: 10.47009/ajmr.2020.9.2.pt1
Pratibha Shirvastava, S. Dutta
Background: Blood transfusion is very common in present era. Now day’s whole blood transfusion is common but also the blood product like red blood cell, white blood cell, platelets, clotting factor, plasma can be done .the aim of study to know the storage related changes in whole blood, packed red blood cell. Subjects and Methods: In our institution we have selected 100 voluntary blood donors sample in blood bank of Teerthankar Mahaveer medical college and research centre, Moradabad up to 12 month. Results: The store blood is Followed up to 35th days .during regular interval 1st, 7th, 14th, 21st, 28th and 35th day, in the blood there is significant change in and all other component in all sample. Conclusion: In the case of storage of blood in blood bank. As the number day of store is more the haematological changes is more significant.
背景:输血在当今时代非常普遍。目前全血输注已很普遍,但红细胞、白细胞、血小板、凝血因子、血浆等血液制品也可输注。本研究的目的是了解全血、填充红细胞的储存相关变化。研究对象和方法:我们在莫拉达巴德Teerthankar Mahaveer医学院和研究中心的血库中选择了100名自愿献血者,为期12个月。结果:库血随访至第35天,在第1、7、14、21、28、35天的定期间隔内,所有样本血液中各成分均有显著变化。结论:在血库储存血液的情况下。贮藏天数越长,血液学变化越显著。
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引用次数: 0
Knowledge, Attitude and Practice toward legalization of abortion among female students of Sabiyan secondary and preparatory school, Dire Dawa, Eastern Ethiopia, 2018. A descriptive cross-sectional study 2018年,埃塞俄比亚东部迪勒达瓦萨比扬中学和预科学校女学生对堕胎合法化的认识、态度与实践一项描述性横断面研究
Pub Date : 2020-07-06 DOI: 10.47009/ajmr.2020.9.2.cm1
Legesse Abera, Adisalem Debebe
Background: Ethiopian abortion law is relatively liberal, but due to lack of knowledge and negative attitude toward legalization of abortion among most women, shortage of safe abortion services provision and significant amount of sociocultural pressures women still go to unsafe abortion service. So the objective of this study was to assess the knowledge, attitude and practice toward legalization of abortion among female students of Sabiyan secondary school, Dire Dawa, March 20-30/ 2018. Subjects & Methods:   The study was conducted in Dire Dawa city,   in Sabiyan high school. An institutional based cross-sectional survey was employed on randomly selected female students. Data was collected using pre- tested self-administered questionnaire and analyzed using computer software SPSS version 24.0. Tables, graphs and charts were used for some variable to describe the results of the study. Results: A total of 320 regular female students were included making the response rate of 100%. Ethiopian abortion law was assessed only 40 (12.5%) of participants were knowledgeable and only 98 (30.6%) of the respondents were having positive attitude. Out of 24 (7.5%) who ever get pregnant, 15 (4.7%) seek for unsafe abortion and only 7 (2.2%) were having experience (practice) of legal abortion. Conclusion: there was a low level of knowledge of the revised Ethiopian abortion law among study participants and majority of the participants had a negative attitude towards legal abortion services and only few of them had practice of legal abortion. So focusing on awareness creation strategy by each stakeholder is an important.
背景:埃塞俄比亚的堕胎法相对宽松,但由于大多数妇女对堕胎合法化缺乏知识和消极态度,缺乏安全堕胎服务,以及大量的社会文化压力,妇女仍然选择不安全堕胎服务。因此,本研究的目的是评估2018年3月20日至30日在德勒达瓦萨比扬中学就读的女学生对堕胎合法化的知识、态度和行为。研究对象与方法:研究在迪勒达瓦市萨比延高中进行。采用基于机构的横断面调查,随机抽取女学生。数据采用预测自填问卷收集,并采用SPSS 24.0软件进行分析。一些变量用表格、图形和图表来描述研究结果。结果:共纳入普通女学生320人,回复率100%。埃塞俄比亚堕胎法被评估,只有40(12.5%)的参与者了解,只有98(30.6%)的受访者有积极的态度。在曾经怀孕的24人(7.5%)中,15人(4.7%)寻求不安全堕胎,只有7人(2.2%)有过合法堕胎的经历(实践)。结论:研究参与者对修订后的埃塞俄比亚堕胎法的了解程度较低,大多数参与者对合法堕胎服务持消极态度,只有少数参与者进行了合法堕胎的实践。所以关注每个利益相关者的意识创造策略是很重要的。
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引用次数: 1
Spectrum of Benign Histopathological Lesions in Cholecystectomy Specimens 胆囊切除术标本良性组织病理病变谱
Pub Date : 2020-07-06 DOI: 10.47009/ajmr.2020.9.2.pt2
Prachi Singh, Faiyaz Ahmad, S. Dutta, S. Awasthi, V. Singh
Background: The most commonly received specimen in any histopathology laboratory is cholecystectomy specimen. The majority of the cholecystectomies are done for Cholelithiasis. Inflammation may be acute, chronic or acute on chronic. It almost always occurs in association with gallstones, which is responsible for carcinoma and if the diagnosed early prognosis of the carcinoma gall bladder is good. Histopathological examination is therefore a must for diagnosis of early carcinomas. Subjects and Methods: 100 cholecystectomy specimens from patients       of all ages were included. All specimens were subjected to gross and microscopic assessment. Different histological findings were noted in various layers of the gall bladder. The study includes all radiologically confirmed inflammatory pathologies of including metaplastic changes of the gall bladder epithelium, irrespective of age and sex. The study excludes patients with evident gallbladder malignancy, cases with known secondaries from gall bladder, traumatic rupture of gallbladder. Results: The age of patients varied from 16 to 70 years, with a maximum number of patients (25%) belong to 31 to 40 years. Gall stones were associated with 59% cases of cholecystitis. Pigment stones were most common (74%). Histopathologically the most common diagnosis was chronic cholecystitis (69%). Conclusion: Almost all of the gallbladder lesions are inflammatory in origin, of which the most common disease being chronic cholecystitis. Chronic cholecystitis was found to be most probable diagnosis in a female of 30-40 years. Pigmented gall stones were found to be the most common etiology of chronic cholecystitis. Prompt detailed histopathological analysis will help to confirm the benign nature of the disease or to detect any precursors of malignancy.
背景:在任何组织病理学实验室最常收到的标本是胆囊切除术标本。大多数胆囊切除术是为了治疗胆石症。炎症可分为急性、慢性或急性上慢性。它几乎总是与胆结石有关,这是导致癌症的原因,如果诊断出早期预后良好的胆囊癌。因此,组织病理学检查是诊断早期癌的必要条件。对象和方法:选取100例不同年龄的胆囊切除术标本。所有标本均经过肉眼和显微镜检查。胆囊各层的组织学表现不同。该研究包括所有放射学证实的炎症病理,包括胆囊上皮化生变化,而不考虑年龄和性别。本研究排除了明显的胆囊恶性肿瘤患者、已知的胆囊继发病例、外伤性胆囊破裂病例。结果:患者年龄在16 ~ 70岁之间,31 ~ 40岁的患者最多,占25%。胆结石与59%的胆囊炎病例相关。色素结石最常见(74%)。组织病理学上最常见的诊断是慢性胆囊炎(69%)。结论:胆囊病变几乎都是炎症性的,其中以慢性胆囊炎最为常见。慢性胆囊炎最常见于30-40岁的女性。色素性胆结石是慢性胆囊炎最常见的病因。及时详细的组织病理学分析将有助于确认疾病的良性性质或发现任何恶性肿瘤的前兆。
{"title":"Spectrum of Benign Histopathological Lesions in Cholecystectomy Specimens","authors":"Prachi Singh, Faiyaz Ahmad, S. Dutta, S. Awasthi, V. Singh","doi":"10.47009/ajmr.2020.9.2.pt2","DOIUrl":"https://doi.org/10.47009/ajmr.2020.9.2.pt2","url":null,"abstract":"Background: The most commonly received specimen in any histopathology laboratory is cholecystectomy specimen. The majority of the cholecystectomies are done for Cholelithiasis. Inflammation may be acute, chronic or acute on chronic. It almost always occurs in association with gallstones, which is responsible for carcinoma and if the diagnosed early prognosis of the carcinoma gall bladder is good. Histopathological examination is therefore a must for diagnosis of early carcinomas. Subjects and Methods: 100 cholecystectomy specimens from patients       of all ages were included. All specimens were subjected to gross and microscopic assessment. Different histological findings were noted in various layers of the gall bladder. The study includes all radiologically confirmed inflammatory pathologies of including metaplastic changes of the gall bladder epithelium, irrespective of age and sex. The study excludes patients with evident gallbladder malignancy, cases with known secondaries from gall bladder, traumatic rupture of gallbladder. Results: The age of patients varied from 16 to 70 years, with a maximum number of patients (25%) belong to 31 to 40 years. Gall stones were associated with 59% cases of cholecystitis. Pigment stones were most common (74%). Histopathologically the most common diagnosis was chronic cholecystitis (69%). Conclusion: Almost all of the gallbladder lesions are inflammatory in origin, of which the most common disease being chronic cholecystitis. Chronic cholecystitis was found to be most probable diagnosis in a female of 30-40 years. Pigmented gall stones were found to be the most common etiology of chronic cholecystitis. Prompt detailed histopathological analysis will help to confirm the benign nature of the disease or to detect any precursors of malignancy.","PeriodicalId":407051,"journal":{"name":"Asian Journal of Medical Research","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131018318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Preoperative and Postoperative Changes in Corneal Astigmatism after Pterygium Excision by Different Techniques 不同手术方法对翼状胬肉切除术后角膜散光变化的评价
Pub Date : 2020-07-06 DOI: 10.47009/ajmr.2020.9.2.ot1
Madhavi Chevuturu
Background: Pterygium causes visual problems due to induced corneal astigmatism or direct encroachment onto the visual axis. The present study was conducted to compare preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques. Subjects and Methods: The present study was conducted from May 2018 to August 20018 on 69 patients of age range 20-55 years of primary Pterygium. Patients were divided into three groups of 23 each. Group I was treated with bare sclera (BS) technique, Group II with conjunctival autograft (CAG) technique and Group III with amniotic membrane graft (AMG) technique. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were recalled on day 5, 1 month, and 3 months for the analysis. Results: Uncorrected visual acuity (UCVA) preoperatively was 0.57, on the 5th day was 0.45 after 1 month was and after 3 months was 35. The mean preoperative astigmatism value in group I was 3.45, in group II was 3.52 and in group III was 3.49. Postoperative astigmatism value in group I was 1.60, in group II was 0.92 and in group III was 0.81. The difference was significant (P< 0.05). Conclusion: Authors found that amniotic membrane graft and a conjunctival autograft is better surgical techniques than bare sclera in reducing astigmatism.
背景:翼状胬肉由于引起角膜散光或直接侵犯视轴而引起视力问题。本研究旨在比较不同手术方法对翼状胬肉切除术后角膜散光的影响。对象和方法:本研究于2018年5月至2008年8月对69例年龄在20-55岁之间的原发性翼状胬肉患者进行了研究。患者分为三组,每组23人。ⅰ组采用裸巩膜(BS)技术,ⅱ组采用自体结膜移植(CAG)技术,ⅲ组采用羊膜移植(AMG)技术。所有患者术前均进行了视力、前、后节、自屈光和自角膜屈光度评估。术后第5天、第1个月和第3个月对患者进行回顾性分析。结果:术前未矫正视力(UCVA)为0.57,1个月后第5天为0.45,3个月后为35。术前平均散光值I组为3.45,II组为3.52,III组为3.49。术后散光值I组为1.60,II组为0.92,III组为0.81。差异有统计学意义(P< 0.05)。结论:羊膜移植和自体结膜移植在减少散光方面优于单纯巩膜移植。
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引用次数: 0
A Study on Clinical Profile, Risk Factors, Angiographic Profile and Short-Term Mortality of Acute Coronary Syndrome in Smokers vs Non Smokers 吸烟者与非吸烟者急性冠脉综合征的临床特征、危险因素、血管造影特征及短期死亡率的研究
Pub Date : 2020-07-06 DOI: 10.47009/ajmr.2020.9.2.me1
B. Reddy, Hemasundar Korrapati, Supraja Chegireddy
Background: Smoking has long been positively associated with the development and progression of coronary heart disease. However, lon- gitudinal cohort studies evaluating smoking habits among cardiac patients as well as the role of socio-demographic factors determining such behaviours are scarce and have been focused on primary care practice. Prevalence of acute coronary syndrome in young individuals is increasing progressively. Previous studies have focused on the analysis of risk factors and to some extent coronary angiographic profile in smokers         vs non-smokers patients with acute coronary syndrome. The aim of the study is to study the acute coronary syndrome in smokers versus non-smokers and to analyse with respect to baseline characteristics. Subjects and Methods: It was a prospective study conducted at Department of Cardiology, Katuri Medical College & Hospital Guntur. Results: In the present study, Acute coronary syndrome occurred seven years earlier in smokers compared with non-smokers (p<0.05) Smokers were frequently male subjects compared with non-smokers (p<0.001) Smokers had a lower prevalence of Diabetes compared with non-smokers (p<0.001) Smokers had a higher prevalence of Obesity compared with non-smokers (p<0.001). Smokers presented with more acute infarctions and less Unstable angina compared with non-smokers (P<0.001). Conclusion: In  the present study, significant differences were observed in coronary risk factor profile between smokers and non-smokers patients with STEMI and NSTEMI/UA. Larger studies will be required to establish specific associations between presentation of acute coronary syndromes and angiographic profiles in smokers.
背景:长期以来,吸烟与冠心病的发生和发展呈正相关。然而,评估心脏病患者吸烟习惯的纵向队列研究以及决定此类行为的社会人口因素的作用很少,并且主要集中在初级保健实践中。急性冠状动脉综合征在年轻人中的患病率正在逐渐增加。以往的研究主要集中在分析吸烟者与非吸烟者急性冠脉综合征患者的危险因素和一定程度的冠状动脉造影特征。本研究的目的是研究吸烟者与非吸烟者的急性冠状动脉综合征,并分析其基线特征。对象与方法:本研究是在Katuri医学院心内科和Guntur医院进行的前瞻性研究。结果:在本研究中,吸烟者发生急性冠脉综合征的时间比不吸烟者早7年(p<0.05);吸烟者多为男性(p<0.001);吸烟者患糖尿病的比例比不吸烟者低(p<0.001);吸烟者患肥胖症的比例比不吸烟者高(p<0.001)。与不吸烟者相比,吸烟者出现更多的急性梗死和更少的不稳定型心绞痛(P<0.001)。结论:在本研究中,吸烟者和非吸烟者STEMI和NSTEMI/UA患者的冠状动脉危险因素谱存在显著差异。需要更大规模的研究来确定吸烟者急性冠状动脉综合征的表现与血管造影之间的具体联系。
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引用次数: 0
Short Segment versus Long Segment Posterior Pedicle Screws Fixation for Treatment of Thoracolumbar Burst Fracture: A Comparative Prospective Study 短节段与长节段后路椎弓根螺钉固定治疗胸腰椎爆裂性骨折:一项前瞻性比较研究
Pub Date : 2020-07-06 DOI: 10.47009/ajmr.2020.9.2.or1
Ashutosh Kumar Singh, S. Bali, Subhajit Maji, K. Ahuja, Nagaraj Manju Moger, S. Mittal, B. Sarkar, P. Kandwal
Background: The surgical treatment of unstable burst fracture (TLICS >4) of the thoracolumbar vertebrae remain controversial. This study is aimed to compare the short segment versus long-segment posterior fixation for thoracolumbar burst fracture.The objective of the study is to study comparison of outcome of the Short-Segment Posterior Fixation (SSPF) versus Long-Segment Posterior Fixation (LSPF) for treatment of thoracolumbar burst fracture in term of surgical, radiological, neurological and functional outcome. Subjects & Methods: In this prospective study, we included 32 patients with Burst fracture AO type A3, A4 of Thoracolumbar spine (T10-L2), who underwent posterior pedicle screw fixation for Burst fracture Thoracolumbar spine. A total of 18 of the patients underwent Short-Segment Posterior Fixation (SSPF) (Group A); group A is further divided into three subgroups A1: short-segment only(n=10), A2: short-segment with index screw(n=4) and A3: short-segment with anterior column reconstruction(n=4) with cage, Whereas 14 patients had Long-Segment Posterior Fixation (LSPF) (Group B). Surgical (duration of surgery, blood loss, complication), Clinical (Oswestry questionnaire, spinal cord independent measuring scale), radiological (percentage of anterior body height compression, kyphosis correction loss, Mc Cormack classification) and Neurological (Frankel grading) outcomes were analyzed. Results:  The operative time Group A (159.85 min  22.5) was significantly shorter than Group B (198.7  31.5).  Blood loss was significantly less in Group A (478 ml   259.3) than Group B (865ml   275.7). Kyphosis Correction loss at 6th month follow up in Group A (subgroup A1: 10.7deg  6.2, subgroup A2: 7.1deg  7.4 and subgroup A3: Subgroup A3: 6.1deg  5.2) was higher than that of group B (6.2deg 6.3). Complication (surgical site infection) occurred in Two patients in group B. There was no significant difference in terms of improvement in functional and neurological outcomes among both groups. The functional outcomes as per the SCIM and ODI score at 6th month follow up in group A: 74.7 +-22.29, 31.5+-13.73 respectively, and group B: 73.8+-26.07, 26.7+-17.9, respectively. Conclusion: Short-Segment Posterior Fixation (SSPF) is a significantly decreased duration of surgery and blood loss compare with Long-Segment Posterior Fixation (LSPF). Loss of kyphosis correction in Short-Segment Posterior Fixation (SSPF) may be decreased with index screws or anterior column reconstruction.
背景:胸腰椎不稳定爆裂骨折(TLICS >4)的手术治疗仍存在争议。本研究旨在比较短节段与长节段后路固定治疗胸腰椎爆裂性骨折。本研究的目的是比较短节段后路固定(SSPF)与长节段后路固定(LSPF)治疗胸腰椎爆裂性骨折在外科、放射学、神经学和功能方面的疗效。对象与方法:在本前瞻性研究中,我们纳入32例胸腰椎爆裂性骨折AO型A3、A4 (T10-L2)患者,接受后路椎弓根螺钉固定治疗胸腰椎爆裂性骨折。18例患者行短节段后路固定(SSPF) (A组);A组又分为3个亚组:A1:仅短节段(n=10), A2:短节段带索引螺钉(n=4), A3:B组14例采用长节段后路固定(LSPF)。对手术(手术时间、出血量、并发症)、临床(Oswestry问卷、脊髓独立测量量表)、放射学(前体高度压缩百分比、后凸矫正损失、Mc Cormack分级)和神经学(Frankel分级)结果进行分析。结果:A组手术时间(159.85 min 22.5)明显短于B组(198.7 31.5)。出血量A组(478 ml 259.3)明显少于B组(865ml 275.7)。A组(A1亚组:10.7°6.2,A2亚组:7.1°7.4,A3亚组:6.1°5.2)随访6个月后凸矫正损失高于B组(6.2°6.3)。b组2例患者出现并发症(手术部位感染),两组在功能和神经预后改善方面无显著差异。随访6个月时,A组的SCIM和ODI评分分别为74.7 +-22.29、31.5+-13.73,B组分别为73.8+-26.07、26.7+-17.9。结论:短节段后路固定(SSPF)与长节段后路固定(LSPF)相比,可显著减少手术时间和出血量。短节段后路固定(SSPF)后凸矫正的损失可以通过指数螺钉或前柱重建来减少。
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引用次数: 4
Management of 6 Months old Neglected Talus Neck Fracture: A Case Report with Review of Literature 6个月大忽视距骨颈骨折1例并文献复习
Pub Date : 2020-07-06 DOI: 10.47009/ajmr.2020.9.2.or3
Nagaraj Manju Moger, Pragadeeshwaran J, M. Sarkar, P. Meena
Talus fractures are very rarely seen and account for approximately 1 percent of fractures around the foot and ankle Talar neck fractures are likely to damage the anastomotic ring, resulting in disruption of blood supply to the talar body which leads to significant problems in fracture healing and integrity. Approximately 39 percent of midfoot and ankle fractures could be missed during initial evaluation due to a lack of adequate radiological and clinical examination. Among these missed injuries approximately 50 percent are talus fractures. A 23-year-old male patient came with complaints of pain over the left foot while walking for 6 months. He had a history of falls from 10 feet height 6 months back. He was conservatively managed in a local hospital without any proper diagnosis. He presented to us 6 months later with chronic, dull aching, continuous pain which aggravates while walking and standing. The diagnosis of the non-union fracture neck of talus was made after radiology and was managed by open reduction and internal fixation with cannulated cancellous screws along with ipsilateral iliac crest cancellous bone grafting. Lack of timely diagnosis escalates the vascular insult, delays timely intervention, and increases morbidity.
距骨骨折非常罕见,约占足部和踝关节周围骨折的1%距骨颈骨折很可能破坏吻合环,导致距骨体血液供应中断,从而导致骨折愈合和完整性方面的重大问题。由于缺乏足够的放射学和临床检查,大约39%的足中部和踝关节骨折在最初评估时可能被遗漏。在这些遗漏的损伤中,大约50%是距骨骨折。一名23岁男性患者来就诊,主诉走路时左脚疼痛6个月。六个月前他曾从10英尺高的地方摔下来。他在当地一家医院接受了保守治疗,没有得到任何适当的诊断。6个月后,他向我们提出慢性,隐痛,持续疼痛,行走和站立时加剧。影像学诊断距骨颈骨折不愈合,采用切开复位、空心松质螺钉内固定及同侧髂骨松质骨移植治疗。缺乏及时的诊断会加剧血管损伤,延误及时的干预,并增加发病率。
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Asian Journal of Medical Research
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