Cranial bony decompressions in the management of head injuries: Decompressive craniotomy or craniectomy?

Objective: Decompressive surgery is one of the available options in dealing with traumatic brain injury (TBI) when clinical and radiological evidence confirm that medical treatment may be insufficient. This can be achieved either by complete removal of the bone or by allowing it to float, but the indications and utility of these are yet to be resolved. This study examines the indications and outcome for both procedures.Materials and Methods: Review of all cases of bony decompression done at the Memfys Hospital for Neurosurgery, Enugu, Nigeria from August 2002 to May 2010. Prospectively recorded data of CT, MRI, operating room, clinics and wards were utilized.Results: There were 38 patients out of whom 35 were males and 3 females. The mean age was 36 years (range 15-80). The causes of the predisposing TBI were road traffic accidents (RTA) (79%), gunshot (10.5%), and assault (7.9%). Decompressive surgery was unilateral in 36 and bi-frontal in 2. Decompressive craniectomy with bone stored in anterior abdominal wall pocket was done in 8 patients and decompressive craniotomy with bone left in situ in 30. Of the latter, bone was unsecured and allowed to float in 13 and the craniotomy was lightly anchored with sutures in 17 patients. Surgery was performed within 24 h in 68.4% of cases. Mortality was 21.1% overall but was up to 25% in the more severely injured patients who had craniectomy.Conclusion: Bony decompression is useful in the management of head trauma. Careful selection of cases and appropriate radiological assessment are important and will guide decision for either craniotomy or craniectomy.Key words: Craniectomy, craniotomy, trauma flap, traumatic brain injur

Neuroimaging findings in pediatric patients with seizure from an institution in Enugu

Background: Pediatric seizures in developing countries are often poorly investigated and consequently poorly managed. Sociocultural misconceptions, financial difficulties, and lack of facilities are often blamed. This study studies the structural intracranial abnormalities associated with pediatric seizures and the proportion of these structural lesions that may benefit from surgery.Methods: Prospective study of 311 pediatric patients referred with seizure disorders, for computed tomography and magnetic resonance imaging to the Memfys Hospital for Neurosurgery, Enugu, between 2003 and 2014. All patients had contrast studies. Angiography was done for selected cases. Demography, imaging findings, and potential benefits of surgery were analyzed using descriptive and inferential statistics.Result: Analysis of 311 patients representing 21% of all pediatric head scans. Male to female ratio was 1.2:1.0. Definite structural lesion was identified in 53.4%. Lesions that may benefit from surgery were identified in 27.7% of all cases representing 51.8% of abnormal scan findings. Under.5 had the least scan rate of 25.1% compared with 42.4% in the adolescents. Although the older age groups had more abnormal findings, the proportion of abnormal to normal scan findings was the highest (1.7:1.0) in the under.5. Under.5 age group had more lesions that may benefit from surgery (P = 0.001). Intracranial tumor was diagnosed in 10.6%, vascular abnormalities (10.3%), hydrocephalus (5.8%), brain abscess (2.9%), and chronic subdural hematoma (2.6%) (P = 0.001).Conclusion: Structural lesions are common and diverse in pediatric seizures. Significant proportion of these patients may benefit from surgery, and these benefits override financial and sociocultural  considerations.Key words: Convulsion, imaging, pediatrics, surger

Dandy Walker malformation (variant): late presentation with childhood blindness

We present a rare case of Dandy Walker Syndrome in a child who presents with complaints of frontal headache, neck pain, fever, progressive visual impairment and multiple generalized tonic clonic seizures, inability to stand and urinary incontinence. Given the clinical and neuro-imaging findings, the diagnosis of Dandy Walker Variant was made. Post surgical recovery (Ventriculo peritoneal shunt) was remarkable. Unfortunately he never regained sight. The purpose of presenting this case report is to highlight the distinctive manifestation of Dandy walker syndrome to enhance early diagnosis, prompt intervention and better outcomeKeywords: Dandy Walker syndrome; congenital brain malformation; childhood blindness; hydrocephalu

The association between isolated oligohydramnios at term and pregnancy outcome and perinatal outcome in case of isolated oligohydramnosis: a retrospective analysis

Background: Current study was carried out to assess the impact of isolated oligohydramnios on perinatal outcomes and mode of delivery.Methods: A retrospective observational cohort study was conducted at term pregnancy with sonographic finding of isolated oligohydramnios (AFI 5-25 cm).Results: When compared to the normal AFI, women with oligohydramnios had significantly lower birth weight babies and were delivered at a significantly earlier gestational age. However there was no difference in the APGAR scores at birth and NICU admissions between the two groups. Reactive NST had more chances of good APGAR score at 1 and 5 minute and that lower the AFI more the probability of nonreactive NST and abnormal Doppler. The number of inductions and caesareans done for foetal reasons were significantly higher in the exposed group.Conclusions: Obstetric and perinatal outcome remains similar in both isolated oligohydramnios with reactive NST as well as in patients with normal amniotic fluid index. Isolated oligohydramnios is not associated with adverse perinatal outcomes. However, it increases the risk for labour induction and caesarean section

Minimization of End-to-End Delay for an Improved Dual-Sink Cluster-Based Routing in WBAN

Wireless Body Area Networks (WBANs) are an integral part of a Wireless sensor network, where sensor nodes are strategically placed in the human body to sense physiological signals and transmit them to the medical personnel via server for medical observations. Every sensor node in WBANs has a general limitation in energy efficiency, end-to-end delay, residual energy, etc. Also, the high energy consumption in WBANs is mainly due to the number of hops covered during physiological signal transmission. This work developed a hop-distance scenario to address these challenges and improve on what others have done. It buffered traffic estimation schemes to minimize end-to-end delay and the total network energy efficiency. This work minimizes end-to-end delay dual-sink cluster-based routing in WBANs by improving the existing dual-sink-sink cluster-based scheme (iDSCB). The simulation result shows that the Minimization of end-to-end delay of the improved dual-sink cluster-based (iDSCB) enhanced the performance of the current article DSCB in terms of end-to-end delay and residual energy by 3.15% and 8.88%, respectively

Comparable endocrine and neuromuscular adaptations to variable vs. constant gravity-dependent resistance training among young women.

BACKGROUND:Variable resistance has been shown to induce greater total work and muscle activation when compared to constant resistance. However, little is known regarding the effects of chronic exposure to variable resistance training in comparison with constant resistance training. The aim of the present study was therefore to examine the effects of chain-loaded variable and constant gravity-dependent resistance training on resting hormonal and neuromuscular adaptations. METHODS:Young women were randomly assigned to variable resistance training (VRT; n = 12; age, 23.75 ± 3.64 years; and BMI, 26.80 ± 4.21 kg m-2), constant resistance training (CRT; n = 12; age, 23.58 ± 3.84 years; BMI, 25.25 ± 3.84 kg m-2), or control (Con; n = 12; age, 23.50 ± 2.93 years; BMI, 27.12 ± 12 kg m-2) groups. CRT performed 8-week total-body free-weight training three times per week with moderate-to-high intensity (65-80% 1RM; periodized). VRT was the same as CRT but included variable resistance via chains (15% of total load). Resting serum samples were taken before and after the 8-week intervention for GH, IGF-1, cortisol, myostatin, and follistatin analyses. RESULTS:Both VRT and CRT groups displayed moderate-to-large significant increases in GH (197.1%; ES = 0.78 vs. 229.9%; ES = 1.55), IGF-1 (82.3%; ES = 1.87 vs. 66%; ES = 1.66), and follistatin (58.8%; ES = 0.80 vs. 49.15%; ES = 0.80) and decreases in cortisol (- 19.9%; ES = - 1.34 vs. - 17.1%; ES = - 1.05) and myostatin (- 26.9%; ES = - 0.78 vs. - 23.2%; ES = - 0.82). Also, VRT and CRT resulted in large significant increases in bench press (30.54%; ES = 1.45 vs. 25.08%; ES = 1.12) and squat (30.63%; ES = 1.28 vs. 24.81%; ES = 1.21) strength, with no differences between groups. CONCLUSIONS:Implementing chain-loaded VRT into a periodized resistance training program can be an effective alternative to constant loading during free-weight RT among untrained young women

Pattern of Presentation and Surgical Management of Spine Tumors in Southeast Nigeria over a 10‑Year Period

Background: Spine tumors could affect the bony elements and/or its neural contents. Clinical manifestations are underlined by their biological behaviors. Aim: This study aims to identify the pattern of presentation and surgical management of spine tumors in southeast Nigeria over a 10-year period. Patients and Methods: A retrospective analysis of patients who were managed surgically for the spine and spinal cord neoplastic lesions over a 10-year period. All patients had pre-and post-operative magnetic resonance imaging (MRI) and histological diagnosis. Relevant clinical, radiological, and histological data were extracted and analyzed using Statistical Package for the Social Sciences (SPSS) for windows version 21. Results: Four hundred and seventy-two spine procedures performed within the study period, 39 cases of histologically proven primary spinal cord tumors (PSCT) and non-PSCT were identified. These represented 8.3% of spine procedures. Seventeen were PSCT (3.6% of spine procedures), while 22 (4.7%) had non-PSCT, mean age for the PSCT group was 45 yrs and non-PSCT 59.5 years. A total of 56.5% of tumors are involved in the thoracic region, 43.7% in the cervical region. PSCT was likely to affect the cervical spine; while bony spine tumors, thoracic spine [odds ratio (OR) 4.9, P value 0.019]. A total of 84.6% of non-PSCT affected the bony spine, mainly the vertebral body. The histological result showed metastatic adenocarcinoma to be the most common tumor (33.3%). PSCT was likely to be benign than non-PSCT (P value < 0.00001). Gross total resection (GTR) was done in 100% of PSCT, and 50% in non-PSCT. Thirteen (40.6%) patients improved and 11 (34.4%) patients remained the same. Conclusions: Metastatic adenocarcinoma was the most common tumor of the spine. There was restricted ability at a GTR for non-PSCT compared to PSCT. Grossly 75% had improved/same neurological status, as such adjudged as a good outcome

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Not AvailableThe combining abilities for physical-quality traits in peanut were examined to understand the type of gene action governing these traits, and to identify peanut genotypes suitable for use as parents in breeding for quality improvement. The F1 hybrids including reciprocals from a six-parent diallel cross along with the parents were evaluated in a randomised complete block design. Data were recorded on five quality traits in peanut viz., shelling outturn, 100-pod weight, 100-seed weight, Count and proportion of sound mature seeds. Substantial genetic variability was observed among the hybrids for the traits studied. Diallel analysis indicated that expression of majority of the quality traits is regulated predominantly by additive gene action suggesting possibility of early-generation selection, while non-additive gene action also plays an equally important role in the control of seed size. Significant reciprocal effect for all the traits denoted role of maternal parent in the expression of quality traits and importance of parental selection in quality breeding. Genotypes ICGV 86564 and TPG 41 were good combiners for seed size, while J 11 was a good combiner for improvement of shelling outturn and proportion of mature seeds. Association between general combining ability (GCA) effects and mean performance suggested that the performance per se of the genotype should be a good indicator of its ability to transmit the desirable quality attributes to its progenies. Though performance of crosses was found to be independent of parental GCA status, it is evident that at least one of the parents used in hybridisation should have large pods and seeds for obtaining better segregants.Springe

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Not AvailableField screening of 83 groundnut cultivars was undertaken for two seasons to assess their tolerance of salinity based on plant mortality and yield attributes. During the dry season, soil salinity of 4 dS m−1 at sowing and 6–7 dS m−1 21–98 days after sowing (DAS) caused high mortality without seed formation in any cultivars, however, at salinity 4.5 dS m−1 during sowing and 3.5–3.0 dS m−1 15–80 DAS during wet season, 61 cultivars produced seed. The cultivars ‘VRI 3’, ‘UF 70–103’, ‘TKG 19A’, ‘S 206’, ‘Tirupati 4’, ‘M 522’, ‘Punjab 1’, ‘BG 3’, ‘Somnath’ and ‘ICGV 86590’, with high plant stand during both the seasons and over 75 g m−2 seed yield during wet season, were identified salinity tolerant. However, 15 cultivars with more than 50 g m−2 seed yield were moderately tolerant and 28 cultivars with less than 25 g m−2 seed yield were sensitive to salinityNot Availabl

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