Neonatal Auditory Screening is a Necessity in The Neonatal Intensive Care Unit: Single Center Study

Background: Hearing impairment early in life interferes with normal healthy psychosocial, linguistic and educational development. Neonatal morbidities might be complicated by increased hearing impairment. Aim of the Work: To study the frequency of hearing loss among neonates with morbidities necessitating admission to neonatal intensive care units. Materials and Methods: This cross-sectional study involved screening of 250 neonate on day of discharge from Neonatal Intensive Care Unit (NICU), Children Hospital, Cairo University Hospitals, Egypt during 2020 using evoked otoacoustic emission (EOAE). Automated auditory brain stem response (AABR) was used as a confirmatory test for those who failed EOAE. Results: among the 250 neonates, 70 (28%) failed the screening by EOAE, and hearing loss was confirmed by AABR among 35(14%). Morbidity risk factors that contributed to hearing impairment was prematurity (p = 0.001), low birth weight (p = 0.003), low APGAR score at 1 and 5 minutes (p = 0.004), long NICU stay duration (p = 0.001), complications of pregnancy and delivery (p = 0.001 and p = 0.006 respectively), hypoxic ischemic encephalopathy (p = 0.001), intracranial hemorrhage (p = 0.001), meningitis (p = 0.003), mechanical ventilation for more than 5 days (p = 0.005), ototoxic drug use (p = 0.007) and hyperbilirubinemia at level of exchange transfusion (p = 0.001). Conclusion: EOAE and confirmatory AABR non- invasively and objectively detected 14% hearing loss among neonates admitted to NICU. Implementation of screening for hearing impairment among those with morbidity risk factors is a necessity to allow prompt diagnosis and early management of hearing loss

Arthroscopic management of traumatic TFCC tears

Background: Triangular fibrocartilage complex is a critical component of wrist biomechanics, serving important functions in both load transmission and distal radioulnar joint stability. This work aimed to assess the clinical outcome of wrist arthroscopy in the management of triangular fibrocartilage traumatic tears as a diagnostic aid and definitive therapeutic tool in terms of functional restoration, and patients’ satisfaction. Methods: This prospective study included 27 patients diagnosed with TFCC tear. Patients were categorized in two groups: group I: had arthroscopic TFCC debridement for central tears and group II: had an arthroscopic assisted capsular TFCC repair. All patients were subjected to ulna carpal stress test, ballottement of the DRUJ, hand grip, evaluation scores [visual analogue scale, Mayo wrist score and patient-rated wrist evaluation score] and radiographic evaluation. Results: PRWE score was signifcantly improved in patients to whom TFCC debridement was done P <0.01. In patients to whom TC repair was done reported overall improvement of the PRWE score P < 0.02. Conclusions: The two patterns of tears included, and the short term follow up period, but has shown significant improvement following the arthroscopic intervention chosen for each pattern in a reproducible and predictable manner in the majority of our series

Preventable hand injuries: A national audit

Summary: Little is known of the scale of avoidable injuries presenting to medical services on a national level in the UK. This study aimed to assess the type and incidence of preventable wrist and hand injuries (as defined by the core research team) at a national level in the UK. 28 UK hospitals undertook a service evaluation of all hand trauma cases presenting to their units over a 2 week period in early 2021 identifying demographical and aetiological information about injuries sustained. 1909 patients were included (184 children) with a median age of 40 (IQR 25-59) years. The commonest five types of injury were fractures of the wrist; single phalangeal or metacarpal fractures; fingertip injuries; and infection, with the most common mechanisms being mechanical falls and manual labour. This is the first extensive survey of preventable hand injuries in the UK, identifying a need for further work into prevention to reduce healthcare burden and cost. 50% of injuries presenting to hand surgeons are preventable, with the most common injuries being single fractures of the wrist, phalanx and metacarpal. Few preventable injuries were related to alcohol or narcotic intoxication. Further research is needed to identify how to initiate injury prevention measures for hand injuries, particularly focussed towards hand fracture prevention