Cervical scoliosis: clinical and radiographic outcomes

Study Design Retrospective study. Objective Cervical scoliosis is a rare condition that can arise from various etiologies. Few reports on the surgical management of cervical scoliosis exist. Our objective was to evaluate clinical and radiographic outcomes following surgical management of cervical scoliosis. Methods We evaluated our cervical spine surgical database for patients with cervical scoliosis (Cobb angle > 10 degrees) from 2005 to 2010. Demographic data including age, gender, diagnoses, and primary versus revision surgery was collected. Surgical data including procedure (anterior versus posterior), estimated blood loss (EBL), length of surgery, length of hospitalization, and complications was recorded. Preoperative and postoperative Cobb angle measurements and Neck Disability Index (NDI) scores were recorded. Results Cervical scoliosis was identified in 18 patients. We excluded 5, leaving 5 men and 8 women with an average age of 50.7 (median 52, range 25 to 65). The average follow-up was 40 months (median 36.5, range 5 to 87). An anterior-only approach was used in 6 cases (average 4 levels fused), 5 cases were posterior-only approach (average 8.7 levels fused), and 2 cases were combined anterior-posterior approach. The EBL was an average of 286 mL (median 150, range 50 to 900), the average surgical time was 266 minutes (median 239, range 136 to 508), and the average hospital stay was 2.7 days (median 2, range 1 to 7). Complications occurred in 7 patients, and 2 developed adjacent segment pathology. The average coronal Cobb angle preoperatively was 35.1 degrees (median 31, range 13 to 63) and corrected was 15.7 degrees (median 10.5, range 2 to 59) postoperatively (p < 0.005). The average NDI preoperatively was 24.9 (median 26, range 6 to 37) and was reduced to 17.8 (median 18, range 7 to 30) postoperatively (p < 0.02). Conclusion Surgical management of cervical scoliosis can result in deformity correction and improvement in patient outcomes. Higher rates of complications may be encountered

Assessment of Village Chicken Production Systems in Kambata Tambaro and Wolaita Zones, SNNPR, Ethiopia

The study was conducted in four woredas (Damot Gale,Of a, Angacha and Hadero Tunto) the first two of them found in Wolaita zone and two of them in Kambata Tambaro Zone of SNNPR, Ethiopia respectively. A cross-sectional survey was conducted in the study areas to assess village chicken production systems, productive and reproductive performance of village chicken and identifying constraints to village chicken production. Stratified random sampling technique was used to select 240 farming households and administer a pre-tested and structured questionnaire. The results showed that the mean age of interviewed farmers was 37.8±9.3 years; average family size & chicken owned per household were 6.8±2.4 persons and 8.6±1.7 heads, respectively. There was no significant differences (p≥0.05) found among the four woredas in all the above traits. The average number of clutch and eggs per hen per year of local chicken in the study areas were 4±0.87 and 12.9±3.47 respectively

Preoperative Patient Reported Outcomes Measurement Information System Scores Assist in Predicting Early Postoperative Success in Lumbar Discectomy

Study Design. Retrospective review of prospective data. Objective. Determine whether patient reported outcome (PRO) data collected prior to lumbar discectomy predicts achievement of a minimal important difference (MID) after surgery. Compare ability of PRO and clinical information to predict achievement of MID in short term follow-up after discectomy. Summary of Background Data. We investigated the ability of patient reported outcomes measurement information system (PROMIS) and clinical factors at the preoperative time point to determine patients achieving MID after surgery. Methods. PROMIS physical function (PF), pain interference (PI), and depression (D) scores were assessed at evaluation and follow-up for consecutive visits between February, 2015 and September, 2017. Patients with preoperative scores within 30 days prior to surgery and with scores 40 days or more after surgery who completed all PROMIS domains were included yielding 78 patients. MIDs were calculated using a distributionbased method. A multivariate logistic regression model was created, and the ability to predict achieving MID for each of the PROMIS domains was assessed. Cut-off values and prognostic probabilities were determined for this model and models combining preoperative PROMIS with clinical data. Results. Preoperative PROMIS scores modestly predict reaching MID after discectomy (areas under the curve [AUC] of 0.62, 0.68, and 0.76 for PF, PI, and D, respectively). Preoperative cutoff scores show patients who have PF and PI scores more than 2 standard deviations, and D more than 1.5 standard deviations worse-off than population mean are likely to achieve MID. The combination of PROMIS with clinical data was the most powerful predictor of reaching MID with AUCs of 0.87, 0.84, and 0.83 for PF, PI, and D. Conclusion. PROMIS scores before discectomy modestly predict improvement after surgery. Preoperative PROMIS combined with clinical factors was more predictive of achieving MID than either clinical factors or PROMIS alone. Key words: herniated lumbar disc, lumbar discectomy, patient reported outcome, patient reported outcomes measurement information system

Demonstration and Evaluation of Dual Purpose Chicken “Potchefstroom Koekoek” Packages at Areka areas, SNNPR, Ethiopia

The demonstration was conducted in Wolaita zone, Boloso Sore district at Areka and around Areka areas. Participants (farmers) were selected purposively on the basis of willingness to construct poultry house; to cover all the associated package costs and record the required was selected. Survival of chicks during the first 8 weeks of brooding using hay-box at the farmers management condition was 79.8% (359 were survived out 450). On average about 93.1% of the chicken were survived to the laying age while mortality reduced from 20.2% to 6.9%. The average age at first egg-laying recorded at each farmers was 142 days and average weight of eggs at first laying was 40.2g. The average weight of male and female chicken at 20 weeks of age was 1.5kg and 1.1kg respectively. Field day was arranged when they were at the age of 20 weeks and 135 (120 male and 15 female) farmers and 65 (60 male and 5 female) researchers, experts and government officials from regional to woredas levels were participated on field day and awareness creation was created as a result all participants got a conviction to consider the technology as a viable agricultural venture

Neck pain following laminoplasty

Cervical laminoplasty, a surgical technique pioneered in Japan, is used increasingly in the United States. Axial neck pain following laminoplasty has been previously reported.1–9 This concern over postoperative neck pain may deter som

A Prospective Study of Causes of Illness and Death in Preterm Infants in Ethiopia: The SIP Study Protocol

Background With nearly 15 million annual preterm births globally, preterm birth is the most common cause of neonatal death. Forty to 60 % of neonatal deaths are directly or indirectly associated with preterm mortality. As countries aim to meet the Sustainable Development Goals to reduce neonatal mortality, significant reductions in preterm mortality are needed. This study aims to identify the common causes of preterm illness and their contribution to preterm mortality in low-resource settings. This article will describe the methods used to undertake the study. Methods This is a prospective, multi-centre, descriptive clinical study. Socio-demographic, obstetric, and maternal factors, and clinical and laboratory findings will be documented. The major causes of preterm mortality will be identified using clinical, laboratory, imaging, and autopsy methods and use the national Ethiopian guidelines on management of preterm infants including required investigations to reach final diagnoses. The study will document the clinical and management protocols followed in these settings. The approach consists of clinical examinations and monitoring, laboratory investigations, and determination of primary and contributory causes of mortality through both clinical means and by post-mortem examinations. An independent panel of experts will validate the primary and contributory causes of mortality. To obtain the estimated sample size of 5000 preterm births, the study will be undertaken in five hospitals in three regions of Ethiopia, which are geographically distributed across the country. All preterm infants who are either born or transferred to these hospitals will be eligible for the study. Three methods (last menstrual period, physical examination using the New Ballard Score, and ultrasound) will be used to determine gestational age. All clinical procedures will be conducted per hospital protocol and informed consent will be taken from parents or caretakers prior to their participation in the study as well as for autopsy if the infant dies. Discussion This study will determine the major causes of death and illness among hospitalized preterm infants in a low-resource setting. The result will inform policy makers and implementers of areas that can be prioritized in order to contribute to a significant reduction in neonatal mortality

Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Funding: Bill & Melinda Gates Foundation