The Safety and Efficacy of Cervical Laminectomy and Fusion versus Cervical Laminoplasty Surgery in Degenerative Cervical Myelopathy: A Prospective Randomized Trial

BACKGROUND: There is a lack of evidence of whether degenerative cervical myelopathy (DCM) is best treated through cervical laminoplasty (CLP) or cervical laminectomy with lateral mass fusion due to the lack of prospective randomized studies that are well designed. We conducted the largest prospective randomized trial to date to determine the comparative effectiveness and safety of both approaches. METHODS: In this prospective, randomized trial, we randomly assigned patients who had symptoms or signs of DCM to undergo either cervical laminectomy and lateral mass fixation (CLF) or CLP. The primary outcome measures were the change in the Visual Analog Scale (VAS), neck disability index, modified Japanese Orthopedic Association (mJOA) score, and Nurick’s myelopathy grading 1 year after surgery. The secondary outcome measures were the intraoperative, post-operative complications, hospital stay, C2-7 Cobb’s angle, and Odom’s criteria. The follow-up period was at least 1 year. RESULTS: A total of 30 patients (mean age, 54.5 ± 5.5 years, 70% of men) underwent prospective randomization. There was a significantly greater improvement in neck pain (VAS) in the CLF group at 1 year (p < 0.05). The improvement in the mJOA and Nurick’s myelopathy grading showed insignificant improvement between both groups. Furthermore, there was no significant difference in the patient’s post-operative satisfaction (Odom’s criteria). The mean operative time was significantly longer in the CLF group (p < 0.001), with no significant difference in the post-operative complications, however, there was a higher rate of C5 palsy, dural tear and infection in the CLF, and a higher rate of instrumentation failure in the CLP. The mean hospital stay was significantly longer in the posterior group (p < 0.05). Finally, there was a significant better improvement in the C2-7 Cobb’s angle at 1 year in the CLF group (p < 0.05). CONCLUSION: Among patients with multilevel DCM, the CLF approach was significantly better regarding the post-operative pain and Cobb’s angle while the CLP was significantly better in terms of shorter hospital stay and operative time

Isothermal PCR for Feasible Molecular Diagnosis of Primary Toxoplasmosis in Women Recently Experienced Spontaneous Abortion

AIM: The current study aimed to assess the practicability of a simple loop-mediated isothermal amplification (LAMP) about real-time quantitative PCR to diagnose primary toxoplasmosis among high-risk pregnant women.METHODS: Cloned Toxoplasma samples were used to calculate the analytical sensitivity while specificity was assessed using pooled DNA samples extracted from other parasitic stages.RESULTS: Both techniques showed 100% sensitivity and specificity and then applied to detect recent Toxoplasma infection in peripheral blood of 77 IgG negative women out of a total 139 women lately experienced spontaneous abortion. The 2 techniques obtained positive results in 8 samples confirming primary toxoplasmosis.CONCLUSION: Generally, LAMP assay is a simple, cost-effective molecular technique can be completed in less than half an hour to diagnose primary Toxoplasma infection. The technique can be applied in a minimally equipped laboratory by ordinary workers to screen the vulnerable groups. Further analysis using larger samples with the quantitative approach is recommended to confirm the sensitivity of this emergent molecular technique

Usefulness of Sunlight and Artificial UV Radiation Versus Chlorine for the Inactivation of Cryptosporidium Oocysts: An in Vivo Animal Study

BACKGROUND: Cryptosporidium is an important waterborne protozoan.AIM: The aim of this study was to investigate the effect of sunlight being the natural source of UV and artificial UV irradiation on Cryptosporidium oocysts versus the effect of chlorination, being the traditional method of water disinfection and to provide an insight into the viability and degree of infectivity of Cryptosporidium oocysts, using an animal model.METHODS: An experimental study including 300 neonatal mice was carried out to investigate the effect of artificial ultraviolet (UV) irradiation and sunlight being the natural source of UV irradiation versus chlorine, the traditionally used water disinfectant on the infectivity of Cryptosporidium oocysts present in water. For each item, nine different exposure times were investigated. Parasitological assessment (Modified Ziehl Neelsen stained stool smears) and histopathological assessment of the excised segments of the small intestine (stained by both Haematoxylin & Eosin and ZN stain) of mice were used to verify the inactivation of oocysts.RESULTS: Cryptosporidium oocysts failed to induce any noticeable infection after 4 hours of artificial UV exposure that provided a UV dose of 10mJ/cm2 and after an 8 hours exposure to sunlight, whereas they showed resistance to disinfection by chlorine.CONCLUSION: The results of the study demonstrate the important role of an 8 hours sunlight exposure of potable water in plastic bottles in achieving complete inactivation of any contaminating Cryptosporidium oocysts, thus offering an applicable, economical and convenient method for the control of cryptosporidiosis especially in developing countries