Hypertrophic olivary degeneration following cerebral trauma managed with rehabilitation - A case report.

Hypertrophic olivary degeneration is a kind of trans-synaptic degeneration, caused by the interruption of dentato rubro olivary pathway. Magnetic resonance imaging (MRI) has been the best modality to show the signals of olivary nucleus hypertrophy. It appears on T2-weighted magnetic resonance imaging as hyper-intensities. Here we present a unique case of a 27-year-old male with traumatic brain injury causing multiple intracranial haemorrhages and functional impairment, which was revealed on computerised tomography. Tracheotomy and thoracic drainage were performed immediately. Anti-infection therapy, brain protection, and comprehensive arousal therapy were part of the intervention along with a comprehensive rehabilitation programme including occupational therapy, balance training, coordination, bed mobility training, and strengthening exercises. A holistic diagnostic approach can reduce the chances of misdiagnosing post-traumatic Hypertrophic Olivary Degeneration cases. We concluded that a comprehensive physical rehabilitation programme and medical treatment works best to heal the lesion and its resulting traumatic symptoms in cases of Hypertrophic Olivary Degeneration cases.

Impact of musculoskeletal disorders on quality of life of patients visiting tertiary care hospital.

OBJECTIVE: To determine the impact of musculoskeletal disorders on patients' quality of life. METHODS: The cross-sectional study was conducted at the Khyber Teaching Hospital, Peshawar, Pakistan, from September 2018 to March 2019, and comprised patients of either gender having a variety of musculoskeletal disorders. Data was collected using a validated EuroQol-5-Dimension-3-Level scale. Data was analysed using SPSS 20. RESULTS: Of the 377 participants, 204(54.1%) were males, and 173(45.9%) were females. The overall mean age was 35.9±12.5 years. Muscular weakness was the most commonly encountered problem 153(40.6%), followed by muscle stiffness 49(13.0%) and adhesive capsulitis 39(10.3%). Patients with musculoskeletal disorders had moderately good 'health state today' score of 56.03±20.175 on VAS. CONCLUSION: Musculoskeletal disorders were found to have a negative impact on quality of life and health status of the patients.

Assessment of the quality of life of spinal cord injury patients in Peshawar.

OBJECTIVE: To assess the quality of life of spinal cord injury patients. METHODS: This cross-sectional study was conducted at Paraplegic Centre Hayatabad, Peshawar, Pakistan, from November 2015 to January 2016, and comprised spinal cord injury patients. A 26-item World Health Organisation quality of life questionnaire was used. Some of the patients were recruited from the paraplegic centre while others participated by filling an online questionnaire. SPSS 20 was used for data analysis. RESULTS: Of the 54 participants, 35(64.8%) were male and 19(35.2%) were female. Besides, 50(92.6%) participants were paraplegic while 4(7.4%) were tetraplegic. The overall mean score for the physical health domain was 54.79±18.39, psychological health domain 52.33±19.37, social relationship 58.79±20.69 and environmental domain 54.11±17.25. CONCLUSIONS: Patients with spinal cord injuries had moderate level of quality of life.

Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies.

Background: Postoperative pulmonary complications remain a leading cause of increased morbidity, mortality, longer hospital stays, and increased costs after cardiac surgery; therefore, our study aims to analyze whether minimally invasive valve surgery (MIVS) for both aortic and mitral valves can improve pulmonary function and reduce the incidence of postoperative pulmonary complications when compared with the full median sternotomy (FS) approach. Methods: A comprehensive systematic literature research was performed for studies comparing MIVS and FS up to February 2021. Randomized controlled trials (RCTs) and propensity score-matching (PSM) studies comparing early respiratory function and pulmonary complications after MIVS and FS were extracted and analyzed. Secondary outcomes included intra- and postoperative outcomes. Results: A total of 10,194 patients from 30 studies (6 RCTs and 24 PSM studies) were analyzed. Early mortality differed significantly between the groups (MIVS 1.2 vs. FS 1.9%; p = 0.005). Compared with FS, MIVS significantly lowered the incidence of postoperative pulmonary complications (odds ratio 0.79, 95% confidence interval [0.67, 0.93]; p = 0.004) and improved early postoperative respiratory function status (mean difference -24.83 [-29.90, -19.76]; p < 0.00001). Blood transfusion amount was significantly lower after MIVS (p < 0.02), whereas cardiopulmonary bypass time and aortic cross-clamp time were significantly longer after MIVS (p < 0.00001). Conclusions: Our study showed that minimally invasive valve surgery decreases the incidence of postoperative pulmonary complications and improves postoperative respiratory function status.