The clinical features of the piriformis syndrome: a systematic review

Piriformis syndrome, sciatica caused by compression of the sciatic nerve by the piriformis muscle, has been described for over 70 years; yet, it remains controversial. The literature consists mainly of case series and narrative reviews. The objectives of the study were: first, to make the best use of existing evidence to estimate the frequencies of clinical features in patients reported to have PS; second, to identify future research questions. A systematic review was conducted of any study type that reported extractable data relevant to diagnosis. The search included all studies up to 1 March 2008 in four databases: AMED, CINAHL, Embase and Medline. Screening, data extraction and analysis were all performed independently by two reviewers. A total of 55 studies were included: 51 individual and 3 aggregated data studies, and 1 combined study. The most common features found were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of the pain with manoeuvres that increase piriformis muscle tension. Future research could start with comparing the frequencies of these features in sciatica patients with and without disc herniation or spinal stenosis

Prevalence of 22q11.2 microdeletion in 146 patients with cardiac malformation in a referral hospital of North India

<p>Abstract</p> <p>Background</p> <p>The 22q11.2 microdeletion syndrome is a common condition that is associated with cardiac as well as extra-cardiac manifestations. Its prevalence and manifestations from north India has not been reported. This study was designed to determine the prevalence and ability of clinical criteria to predict 22q11.2 microdeletion.</p> <p>Methods</p> <p>A total of 146 cases of cardiac malformation requiring tertiary care at a teaching hospital were prospectively screened for 22q11.2 microdeletion using fluorescence in situ hybridization test. Detailed clinical information was obtained as per guidelines of Tobias, <it>et al </it>(1999).</p> <p>Results</p> <p>Nine out of 146 patients (6.16%) was found to have 22q11.2 microdeletion. All the positive patients showed the presence of extra-cardiac features of 22q11.2 microdeletion syndrome. None of the cases with isolated cardiac defect were positive for microdeletion.</p> <p>Conclusions</p> <p>It seems that 22q11.2 microdeletion syndrome is over-suspected in children with isolated congenital heart defects. Screening for 22q11.2 microdeletion should be considered in those cardiac malformation cases which have extra-cardiac manifestations in the form of facial dysmorphism and hypocalcaemia.</p

Doubling up on supersymmetry in the Higgs sector

We explore the possibility that physics at the TeV scale possesses approximate N =2 supersymmetry, which is reduced to the N =1 minimal supersymmetric extension of the Standard Model (MSSM) at the electroweak scale. This doubling of supersymmetry modifies the Higgs sector of the theory, with consequences for the masses, mixings and couplings of the MSSM Higgs bosons, whose phenomenological consequences we explore in this paper. The mass of the lightest neutral Higgs boson h is independent of tan β at the tree level, and the decoupling limit is realized whatever the values of the heavy Higgs boson masses. Radiative corrections to the top quark and stop squarks dominate over those due to particles in N = 2 gauge multiplets. We assume that these radiative corrections fix mh ≃ 125 GeV, whatever the masses of the other neutral Higgs bosons H, A, a scenario that we term the h2MSSM. Since the H, A bosons decouple from the W and Z bosons in the h2MSSM at tree level, only the LHC constraints on H, A and H± couplings to fermions are applicable. These and the indirect constraints from LHC measurements of h couplings are consistent with mA ≳ 200 GeV for tan β ∈ (2, 8) in the h2MSSM