Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 5 Articles
ââ?¬Å?Subarachnoid Hemorrhage is non-traumatic nasty bleeding into the subarachnoid\narea, the territory between the arachnoid and the piamater of the\ncentral nervous system showing prompt developing signs of neurological sequelaeââ?¬Â.\nIt is one among the neurological emergencies which is a very distressing\ncerebrovascular disease with complicated mechanisms that risks brain\nperfusion and its function, having higher morbidity and mortality rates. Its\nmortality rate is still ranged between 8.3% and 66.7%, with noticeable regional\nvariations, beside recent advances in treatment approaches. The incidence of\nSAH among the population of 2 - 22.5/100,000 was reported with a minimum\nof 60% of aneurysm ruptures occurring amid ages of 40 and 60 years with 3:2\nmale:female ratio. The rupture risks for unruptured aneurysms are increased\nby the issues like present smokers, larger size of aneurysm, and amid young\npopulation. The surgical treatment decision should be contemplated upon\nfactors such as aneurysmââ?¬â?¢s size, aneurysmââ?¬â?¢s location, patientââ?¬â?¢s illness history,\nand surgeonââ?¬â?¢s operative experiences. Latest technical progresses in imaging\ntechniques, increased consideration of illness history, more awareness of incidences\nof aneurysms and use of micro neurosurgery, have raised the chance\nfor detection of subarachnoid hemorrhage (SAH) and possible better outcomes\nwith surgical management. Factors that may affect outcome include\nage, size and site of aneurysm, interval between ictus and surgery, CT Fisher\nGrade & Hunt and Hess Grading earlier to surgery, & Glasgow Coma Scale at\nthe while of discharge. The studies here support the wide spread concept that\nsurgical clipping of SAH for Hunt and Hess Grade 4, 5 SAH, which is also considered as poor Grade SAH stipulates an effective treatment if done earlier\nprovides better outcome....
Background: Lumbar burst fractures are common spinal injuries that cause\nsevere instability with kyphotic deformities and neurological complications\nrequiring surgical decompression and reconstruction with spinal instrumentation\nfor unstable burst fracture, but there is controversy about the optimal\nsurgical approach anterior, posterior or combined approach. Objectives: To\nassess the efficacy & safety of anterolateral approach in decompression and\nreconstruction with spinal instrumentation for lumbar burst fractures. Subjects\n& Methods: A retrospective study including 16 patients, 10 males and 6\nfemales with lumbar burst fractures and anterior compression treated operatively\nby anterolateral approach for corpectomy and single level fusion by using\nexpandable cage or mesh cage loaded with bone graft and plat with screws.\nThe clinical and radiological follow up after discharge from the hospital\nranged from 12 to 24 months. Results: All patients improved regarding the\nFrankel score more than one grade after surgery, except 2 cases of grade A\ndidnââ?¬â?¢t improve. Mean preoperative visual analogue scale was 7.4 improving to\n0.9 postoperatively. The mean Local kyphosis improved from 8.8Ã?Å¡ before surgery\nto âË?â??1Ã?Å¡ after surgery. Conclusions: Anterolateral approach is feasible, effective,\nand safe approach for unstable lumbar burst fractures. Angular deformity\nis successfully corrected when the anterior approach is used....
Major depressive disorder (MDD) is associated with changes in autonomic nervous system (ANS) and cognitive impairment.\nHeart rate variability (HRV) and Pulse pressure (PP) parameters reflect influences of the sympathetic and parasympathetic nervous\nsystem. Cortisol exerts its greatest effect on the hippocampus, a brain area closely related to cognitive function. This study aims to\nexamine the effect of HRV, PPG, salivary cortisol levels, and cognitive function in MDD patients by using noninvasive techniques.\nWe have recruited MDD patients, diagnosed based on DSM-V-TR criteria compared with healthy control subjects. Their HRV\nand PP were measured by electrocardiogram (ECG) and photoplethysmography (PPG). Salivary cortisol levels were collected and\nmeasured on the same day.MDD patients exhibited elevated values of mean HR, standard deviation of HR (SDHR), low frequency\n(LF) power, low frequency/high frequency (LF/HF) ratio, mean PP, standard deviation of pulse pressure (SDPP), and salivary\ncortisol levels. Simultaneously, they displayed lower values ofmean of R-R intervals (meanNN), standard deviation of R-R intervals\n(SDNN), high frequency (HF) power, and WCST scores. Results have shown that the ANS of MDD patients were dominated by\nthe sympathetic activity and that they have cognitive deficits especially in the domain of executive functioning....
Background. Psychosocial problems refer to the difficulties faced by adolescents in different areas of personal and social functioning.\nAdolescents are vulnerable to psychosocial problems because of physical and physiological changes that occur in their body\nduring this developmental stage. Therefore, this study was conducted to identify psychosocial problems among school going\nadolescents in Nepal. Methods. A cross-sectional descriptive study was adopted. Nonprobability convenient sampling technique\nwas used for selecting 287 adolescents. Ethical approval was taken from Nepal Health Research Council and self-administered\nstructured questionnaire was used for data collection. Data collection was done in 2016. Descriptive statistics and chi-square test\nwere used to analyze the data. Results.The findings of this study show that 12.9 percent of adolescents had psychosocial problems.\nWhile categorizing psychosocial problems, the adolescents had internalizing problems (44.6%), attention deficit hyperactive\ndisorder (ADHD) (25.8%), and externalizing problems (4.2%). There is association of age group and parent�s marital status\nwith psychosocial problems. Conclusion. It is concluded that psychosocial problems (i.e., internalizing problems, ADHD, and\nexternalizing problems) were prevalent among Nepalese school adolescents. Adolescents� age group and parent�s marital status are\nassociated with psychosocial problems. This study recommended that school authority, health professionals, and other professional\nrelated to childhealthandmental health shouldplay animportant role for the prevention and earlier recognition of and intervention\nfor psychosocial problems....
Introduction. The aim of this study was to employ the word-picture paradigm to examine the effectiveness of combined pictorial\nillustrations and sentences as strong contextual cues. The experiment details the performance of word recall in healthy older adults\n(HOA) and mild Alzheimer�s disease (AD). The researchers enhanced the words� recall with word-picture condition and when the\npair was associated with a sentence contextualizing the two items. Method. The sample was composed of 18 HOA and 18 people\nwith mild AD. Participants memorized 15 pairs of words under word-word and word-picture conditions, with and without a\nsentence context. In the paired-associate test, the first item of the pair was read aloud by participants and used to elicit retrieval of\nthe associated item. Results. The findings suggest that both HOA and mild-AD pictures improved item recall compared to word\ncondition such as sentences which further enabled item recall. Additionally, the HOA group performs better than the mild-AD\ngroup in all conditions. Conclusions. Word-picture and sentence context strengthen the encoding in the explicit memory task,\nboth in HOA and mild AD. These results open a potential window to improve the memory for verbalized instructions and\nrestore sequential abilities in everyday life, such as brushing one�s teeth, fastening one�s pants, or drying one�s hands....
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