Bairdbertram6896

Hypophosphatasia (HPT) and cleidocranial dysplasia (CCD) are rare genetic disorders characterized by both defective ossification and bone mineralization. Patients usually present with craniosynostosis and cranial defects which in many cases require surgical repair. There is only 1 reported case of combined HPT and CCD in the literature. Our reported case involves a 3.5-year-old girl with concomitant homozygous CCD and heterozygous HPT. The child had an extended cranial defect since birth which improved with the administration of Strensiq and was followed until preschool age. Bone defects were relatively minor on revaluation. Due to the limited final defect, we decided not to intervene. In HPT-CCD patients, bone defects are overestimated due to osteomalacia, and thus, management strategy should be less aggressive. They should undergo surgical repair with cranioplasty with the use of cement and/or titanium meshes in case of extended final defects.

To ascertain the benefits of practicing shunt pumping test on a validated experimental model.

A validated experimental model of shunt was used and 25 medical professionals were asked to assess the block in the model where artificial blocks were created. The assessment was repeated after the participants had practiced on the same model. The performance of participants before and after practice was compared and statistically evaluated.

The ability to predict the status of shunt showed an improvement in all scenarios after practice. The odds ratio for predicting a blocked shunt before and after practice was 7.25 (95% credible interval 1.50-21.01). The odds ratio for predicting a functional shunt before and after practice was 8.81 (95% credible interval of 1.64 to 13.65).

Practicing on the experimental model significantly improves the ability to predict the status of shunt. Training of primary caregivers on similar shunt models based on the shunts used in respective centers can improve an early detection of shunt block and reduce reliance on more invasive and expensive evaluation modalities.

Practicing on the experimental model significantly improves the ability to predict the status of shunt. Training of primary caregivers on similar shunt models based on the shunts used in respective centers can improve an early detection of shunt block and reduce reliance on more invasive and expensive evaluation modalities.

Early closed reduction and locked intramedullary (IM) nailing has become the standard treatment for diaphyseal long bone fractures in high income countries. GSK J1 molecular weight The low and middle income countries (LMICs) are still lagging behind in transiting from open surgical reduction and non-operative modalities to closed reduction due to lack of requisite equipment. However, some surgeons in LMICs are beginning to achieve closed reduction even without the equipment.

A prospective descriptive study was done on a total of 251 fresh diaphyseal fractures of the humerus, femur and tibia fixed with a locked nail over a 5½-year period. The fractures were grouped into those that had open reduction, closed reduction or reduction with a finger.

Closed reduction was done for 135 (53.8%) fractures belonging to 123 patients. The mean and range of the patients' ages were 41.33 and 13-81years, respectively. Males constituted 69.9% and mostly (48%) sustained fractures in motorcycle accident. There was a significant negative association between closed reduction and fracture-to-surgery interval (p < 0.001). Closed reduction also had positive associations with (i) humerus and tibia fractures (p < 0.001), (ii) middle, distal and segmental fractures (p = 0.025), (iii) retrograde approach to femur fracture nailing (p < 0.001), and (iv) wedge or multifragmentary type femur fractures (p = 0.005).

With constant practice, it is possible to achieve closed reduction of many fresh diaphyseal long bone fractures in spite of the limitations imposed on surgeons in LMICs by poor health systems and grossly inadequate fracture care facilities.

With constant practice, it is possible to achieve closed reduction of many fresh diaphyseal long bone fractures in spite of the limitations imposed on surgeons in LMICs by poor health systems and grossly inadequate fracture care facilities.

To evaluate the available tibial fracture non-union prediction scores and to analyse their strengths, weaknesses, and limitations.

The first part consisted of a systematic method of locating the currently available clinico-radiological non-union prediction scores. The second part of the investigation consisted of comparing the validity of the non-union prediction scores in 15 patients with tibial shaft fractures randomly selected from a Level I trauma centre prospectively collected database who were treated with intramedullary nailing.

Four scoring systems identified The Leeds-Genoa Non-Union Index (LEG-NUI), the Non-Union Determination Score (NURD), the FRACTING score, and the Tibial Fracture Healing Score (TFHS). Patients demographics Non-union group five male patients, mean age 36.4years (18-50); Union group ten patients (8 males) with mean age 39.8years (20-66). The following score thresholds were used to calculate positive and negative predictive values for non-union FRACTING score ≥ 7 at the immede designs are outlined herein to better tackle this devastating, and yet, unsolved problem.

Birth asphyxia may cause neuro-developmental impairment in the affected newborns especially those who had hypoxic-ischemic encephalopathy. Music therapy has been observed to help in reducing pain and stress in newborns and improve neurodevelopmental outcome.

The objective of this study is to determine the effects of music therapy on the outcomes of birth asphyxia.

A randomized controlled trial involving 3095 newborns born between January 2013 and August 2019 with birth asphyxia was conducted in the neonatal intensive care unit of Burdwan Medical College. They were distributed in two groups-A (received music therapy along with coventional management) and B (only received conventional management), using computer-generated randomization. Pain score was assessed during any painful procedure and the neurodevelopmental outcome was measured at 3rd, 6th, 12th, 18th and 24th months. p < 0.01 was considered statistically significant.

A total of 3095 newborns were included with a mean gestation of 34.3 ± 2.1 weeks and 56.7% of them were male. Mean hospital stay, oxygen dependency, requirement of mechanical ventilation and incidence of apnea were significantly lesser among newborns of group A. Newborns of group B showed a significantly higher mean pain score, whereas newborns in Group A exhibited significantly greater mental and motor neurodevelopmental quotients.

Music therapy was observed to help in reducing hospital stay, oxygen dependency, incidences of apnea, pain during procedures and also resulted in better neurodevelopmental outcome. However, before generalizing the findings, further multi-centric research should be undertaken.

Music therapy was observed to help in reducing hospital stay, oxygen dependency, incidences of apnea, pain during procedures and also resulted in better neurodevelopmental outcome. However, before generalizing the findings, further multi-centric research should be undertaken.

Letters of recommendation (LORs) are one of the most important components of the neurosurgical residency application. Studies in other fields and surgical subspecialties have found gender bias.

To determine whether neurosurgical LORs contain significant linguistic gendered differences.

We performed a retrospective review and linguistic analysis of all LORs submitted on behalf of applicants offered an interview invitation to a single neurosurgical residency program at an academic medical center between 2015-2016 and 2018-2019.

A total of 599 letters from 156 applicants (120 males and 36 females) were included. Background demographics, including United States Medical Licensing Examination (USMLE) Step 1 score and publications, were not significantly different between applicants. Male faculty authored 93% of all letters. Female faculty were more likely to write letters for female applicants than male applicants (12.1%vs 5.5%, P <.001). Letters for women were significantly longer (334 words vs 277 words, P <.001). Overall, 1754 agentic terms and 854 communal terms were coded. Letters for men contained significantly fewer agentic terms (10.7vs 13.1, per applicant, P <.01) and communal terms (5.2vs 6.4, P <.034). This difference, however, is nonsignificant when word count was used as a covariate. Female applicants were more significantly likely to be labeled "Outstanding" (2.4vs 1.6 mentions per applicant).

Overall, there are more similarities than differences between genders in LORs for neurosurgical applicants. This finding is at odds with what has previously been reported in most other surgical specialties.

Overall, there are more similarities than differences between genders in LORs for neurosurgical applicants. This finding is at odds with what has previously been reported in most other surgical specialties.

Normal pressure hydrocephalus (NPH) is frequently treated with ventriculoperitoneal shunt (VPS) surgery. However, VPS implantation can lead to overdrainage and complications such as headaches, hygroma, and subdural hematoma due to a siphon effect in an upright position. Gravitational valves prevent overdrainage through position-dependent adjustment of valve resistance. Flow-regulated valves that increase resistance in presence of high cerebrospinal fluid flow may provide similar protection against overdrainage and present an alternative to gravitational valves.

To compare gravitational and flow-regulated shunt valves in patients with symptomatic NPH.

We performed a retrospective analysis of 97 patients suffering from NPH who underwent VPS implantation with a gravitational or a flow-regulated valve. The primary endpoint was the occurrence of hygroma or subdural hematoma. Secondary endpoints were neurological outcome (Kiefer score, Stein and Langfitt score, and NPH recovery rate), frequency of valve adjusments and reoperations.The coronavirus disease of 2019 pandemic has brought not only disaster to humanity but also the best in each human individual. Filipinos, in a special way, have exhibited the inherent greatness of the human person in the construction of the community pantries where people who can sustain their needs in time of pandemic would donate some provisions to those who are needy. The establishment of various community pantries across the Philippines embodies the spirituality of 'Alay Kapwa', a spirituality that connects people together especially in time of crisis to be persons for others rather than harboring an unnaturalistic human and primitive attitude of self-centeredness.

Current intraoperative orientation methods either rely on preoperative imaging, are resource-intensive to implement, or difficult to interpret. Real-time, reliable anatomic recognition would constitute another strong pillar on which neurosurgeons could rest for intraoperative orientation.

To assess the feasibility of machine vision algorithms to identify anatomic structures using only the endoscopic camera without prior explicit anatomo-topographic knowledge in a proof-of-concept study.

We developed and validated a deep learning algorithm to detect the nasal septum, the middle turbinate, and the inferior turbinate during endoscopic endonasal approaches based on endoscopy videos from 23 different patients. The model was trained in a weakly supervised manner on 18 and validated on 5 patients. Performance was compared against a baseline consisting of the average positions of the training ground truth labels using a semiquantitative 3-tiered system.

We used 367 images extracted from the videos of 18 patients for training, as well as 182 test images extracted from the videos of another 5 patients for testing the fully developed model.