Sacral agenesis without maternal diabetes: a case report.

Introduction: Sacral agenesis is a rare congenital condition that is characterized by sacrococcygeal bone agenesis. It is associated with spinal cord anomalies as well as problems with the genitourinary system, large bowel, and lower extremities. Fetal ultrasound allows for diagnosis even before birth. Case presentation: The authors present the case of a 1-year-old girl with sacral agenesis type III and bilateral congenital talipes equinovarus with spina bifida who was born to a nondiabetic mother and had a normal anomaly scan. Clinical discussion: People with less severe forms of sacral agenesis can live a normal life, and it is not connected with cognitive impairment; however, concomitant bladder, colon, and lower limb disorders cause considerable morbidity. The majority of treatment is supportive, frequently requiring orthopedic, urological, gastroenterological, pediatric, and physiotherapy support. Conclusion: Genetic and prepregnancy counseling, as well as early screening of high-risk mothers, remain the only options for prevention of the disease since treatment is mostly supportive.

Traumatic Thoracic and Lumbar Spine Injury in Adult Population Presenting to a Tertiary Care Hospital.

BACKGROUND: Epidemiology of traumatic thoracolumbar spine injury is a less explored subject in developing/ underdeveloped countries. The number of available studies in Nepal is even smaller. This study aims to establish the epidemiological characteristics of patients with thoracic and lumbar spine injuries presenting to Dhulikhel Hospital, Kathmandu University Hospital in Nepal. METHODS: This is a single-center retrospective observational study. Patients with traumatic thoracolumbar spine injuries admitted to to Dhulikhel Hospital, Kathmandu University Hospital from 2015 January to 2019 December were included. International Spinal Cord Injury core data set (version 2) and International Spinal Cord Injury Spinal Column Injury Basic Data Set (version 1.0) were used for data collection. RESULTS: Three hundred and seventeen patients were included, of which, 50.2% were male and the mean age was 45.5 ± 17 years. Fall was the most common etiology of injury (69.1%). The most common level of injury was L1 (32.5%). Thirty-seven patients (11.7%) had ASIA A neurology. One hundred and seventy-three (54.6%) patients underwent surgical intervention. The median hospital stay of the patients was 7 days (IQR: 3-11) with no recorded in-hospital mortality. CONCLUSIONS: Males and females are equally vulnerable to thoracic and lumbar spinal injuries, with the majority of patients in 46-60 age groups. More than 1/3rd neurologically impaired patients are with ASIA A neurology. The findings of this study can contribute to traumatic thoracic and lumbar spine injury prevention and rehabilitation.

Functional Outcome and Quality of Life Following Total Hip Replacement Surgery.

BACKGROUND: Total hip replacement surgeries are popular treatment modality for degenerative and traumatic hip condition which provides high degree of patient satisfaction and are mainly described in literatures among patient residing in western world. However activities of daily living of people in hilly area of developing country are different from western country but there are paucity of literature describing outcome of these people. METHODS: Retrospective observational study was carried out in a university teaching hospital in Nepal. Patients residing in hilly region of Nepal who underwent total joint replacement of hip joint between 2017 to 2019 AD were included in the study. The functional outcome was measured using Harris Hip Score and the quality of life was assessed using SF-12 Patient Questionnaire preoperatively , 3 months , 6 months and 1 year follow up. RESULTS: More than two-thirds of the patients were male. The mean age group of patients was 45.71 years. The most common indication of surgery was avascular necrosis of femoral head. There was significant improvement in Harris Hip Score upto 6 months postoperatively. Quality of life including both physical and mental component of SF-12 improved significantly upto 6 months. CONCLUSIONS: Total hip replacement surgery significantly improves functional outcome and quality of life of patients residing in hilly region of Nepal. However, long term follow up still is request to find out effect of joint replacement in activities of daily living in these group of people.