Bromidobis(N,N′-diphenyl­thio­urea-κS)copper(I) monohydrate

In the title compound, [CuBr(C13H12N2S)2]·H2O, the CuI atom adopts a slightly distorted trigonal-planar coordination arising from two S atoms of two diphenyl­thio­urea ligands and a bromide ion. There are two intra­molecular N—H⋯Br hydrogen bonds completing twisted six-membered rings with R(6) motifs. The dihedral angles between the aromatic rings in the ligands are 62.11 (13) and 85.73 (13)°. In the crystal, components are linked by N—H⋯O, O—H⋯S and O—H⋯π inter­actions. There also exist π–π inter­actions with a distance of 3.876 (2) Å between the centroids of benzene rings of two different ligands. Together, the inter­molecular inter­actions lead to a three-dimensional network

Microdiscectomy in Relieving Neurological Symptoms in Patients with Lumbar Disc Herniation

Introduction: Minimally invasive spine surgical approaches such as microdiscectomy have gained attention in recent years due to less tissue damage, speedy and acceptable neurological improvement with less complication.Objective: To assess efficacy of microdiscectomy in improving neurological status in patients with lumbar disc herniation.Material and Methods: A Quasi experimental study comprising 70 consecutive cases though non-probability purposive sampling technique of both the sexes admitted in Neurosurgery department, Mayo Hospital operated for the 1st time for any disc pathology with no other spinal lesions giving consent themselves or though legal guardians was conducted. Pain for leg and back was measured pre and post-operatively was done by VAS which had 42 days of follow up. Standard Neurological examinations were conducted pertaining to muscle power (by MRC), sensory status and SLR test pre and post-operatively. Variables according to their nature were expressed in the form of Mean ± SD, Median (Range) and Frequency (percentage). Mc Neumer’s chi square test and paired t test were used to see association between pre-operative and post-operative Neurological status (MRC grade, sensory status, SLR) depending on their nature viz: qualitative or quantitative respectively in SPSS version 15 and hence efficacy of microdiscectomy was assessed.Results: Out of 70 patients 74% were male and 26% were females. Mean ± SD of patients was 37.6 ± 13.0 years. Majority were Laborers after housewives. Illiterates, Poor lifting techniques were the most common characteri-stics in the respective headings of education and employment. Most common level of disc herniation was L4-L5, L5-S1 level (96%) where Prolapse and extrusion were most common MRI findings. As compared to pre-operative (3.4) muscle power 1st and 42nd day power were respectively 4.0 and 4.7 (p = 0.001). Pre-operatively only 32 (45.7%) had normal sensation which improved to 38 (54.3%) and 51 (72.9%) respectively in 1st and 42nd day of surgery (p = 0.001). Pre-operative mean SLR improved to 98.6 degrees in 1st POD and continued to be the same till 42nd day (p = 0.001). All the MRC findings, sensory status and SLR values in each post-operative days were statistically significant with the baseline by paired t test (p = 0.001).Conclusion: Microdiscectomy is one of the effective procedures which can be adopted for symptomatic unilateral lumber disc herniation with significant improvement in Neurological statuses

Primary Soft Tissue Orbital Ewing’s Sarcoma Causing Unilateral Visual Loss: A Case Report

A case of primary Ewing's sarcoma of right orbit causing unilateral visual loss in a 3 year old female child is reported. The child presented with 1 year history of painless unilateral proptosis and loss of vision. Loss of vision due to primary Ewing's sarcoma in orbit is extremely rare and it should be considered as one of the differential diagnoses while dealing the patient with these sorts of clinical presentation

Roles of Sociodemographic Characteristics in Determining Neurological Outcomes in Patients with Lumbar Disc Herniation after Microdiscectomy

Introduction: Socio-demographic characteristics like age, gender, occupation has important role in causation of lumbar disc herniation which may even affect their recovery after the surgery. We want to explore the difference in improvement in Neurological status in terms of difference in socio-demographic characteristics of patients.Objective: To find variation in improvement in Neurological status in post microdiscectomy lumbar disc herniation patient stratified in terms of socio-demographic characteristics.Material and Methods: A Quasi experimental study comprising 70 consecutive cases though non-probability purposive sampling technique of both the sexes admitted in Neurosurgery department, Mayo Hospital operated for the 1st time for any disc pathology with no other spinal lesions giving consent themselves or though legal guardians was conducted. Pain for leg and back was measured pre and post-operatively was done by VAS which had 42 days of follow up. Standard Neurological examinations were conducted pertaining to muscle power (by MRC), sensory status and SLR test pre and post-operatively. Variables according to their nature were expressed in the form of Mean ± SD, Median (Range) and Frequency (percentage). Comparisons between categorical and continuous variables were done with the help of t test and one way ANOVA and comparison between both categorical variables was done with the help of chi square test in SPSS version 15.Results: Out of 70 patients 74% were male and 26% were females. Mean ± SD of patients was 37.6 ± 13.0 years. Majority were Laborers after housewives. Illiterates, Poor lifting techniques were the most common charac-teristics in the respective headings of education and employment. Most common level of disc herniation was L4-L5, L5-S1 level (96%) where Prolapse and extrusion were most common MRI findings. Improvement in motor power, sensory status was not dependent on any of socio-demographic characteristics. Improvement on SLR was associated with male genders on 1st (p = 0.03) as well as 7th, 21st and 42nd PODs (p = 0.001).Conclusion: Except gender in SLR value improvement, no other socio-demographic characteristics alter the improvement status in LDH patient after microdiscectomy

Diagnostic Accuracy Of Lachman Test For Diagnosis Of Anterior Cruciate Ligament Tear In Adults With Knee Injuries Using Arthroscopy As Gold Standard

Abstract Objective: To evaluate the Lachman test's ability to identify an ACL rupture using arthroscopy as the gold standard. Methods: This cross-sectional (validation) study was done from September 2022 to March 2023. Individuals presenting with a knee injury were enrolled and underwent Lachman test and later on arthroscopy and findings will be recorded. SPSS version 25 was used to analyze the collected data. Results: 150 patients were enrolled with a mean age of 39.95 ± 11.46 years. There were 80 (53.3%) male patients and 70 (46.7%) were females. In this study, we observed that the Lachman test had 81.8% sensitivity, 95.2% specificity, PPV & NPV were 93.1% and 87.0%, respectively and diagnostic accuracy of 89.3%. Conclusion: Thus, the Lachman test is a reliable test for the diagnosis of anterior cruciate ligament tear in knee injuries, which can replace arthroscopy and other invasive or expensive modalities.

A monoclinic polymorph of cysteamine hydro­chloride

The title compound (systematic name: 2-mercaptoethan­aminium chloride), C2H8NS+·Cl−, the hydro­chloride salt of cysteamine, in contrast to the previously reported triclinic polymorph [Kim et al. (2002 ▶). Polyhedron, 21, 225–228], crystallized in the monoclinic crystal system. In the crystal, the cysteaminium cations are linked to the chloride anions via one S—H⋯Cl and three N—H⋯Cl hydrogen bonds. Two-dimensional slab-like networks are formed, which are stacked in [100]. This arrangement is similar to that observed in the triclinic polymorph

5-Hydr­oxy-2-methyl-4H-pyran-4-one

The title compound, C6H6O3, is a member of the pyrone family. The mol­ecules are planar (r.m.s. deviation of the asymmetric unit is 0.0248 Å, whereas that of the dimer is 0.0360 Å) and they are dimerized due to inter­molecular O—H⋯O hydrogen bonds. The dimers are connected to each other through hydrogen bonds involving the CH3 group and the hydr­oxy O atom. There are π–π inter­actions between the centroids of the pyrone rings at a distance of 3.8552 (13) Å. A C—H⋯π inter­action also exists between the carbonyl group and the centroid CgA of the pyrone ring, with O⋯CgA = 3.65 (1) Å and C⋯CgA = 4.363 (2) Å

Prognostic Indicators in Patients with Severe Head Injury: A 2 Year Retrospective Experience at Mayo Hospital, Lahore

Introduction: Traumatic brain injury (TBI) is an important public health care problem in the western world and equally being pandemic in the developing world. It is one of the most common causes of death in young adults and it can affect people’s lives enormously. Since many years the prognostic indicators of severe head injury had been field of research. Knowing the factors responsible for poor prognosis and preventing them outcome of severe head injury can be improved.Material and Methods: A retrospective study was conducted analyzing past records of the patients in department of Neurosurgery, Mayo Hospital from Nov 2011 to Nov 2013 with diagnosis of severe head injury (Glasgow Come Scale < 9). All patients except the patients with brain death, associated poly trauma, spinal injuries were excluded from the study. Total sample of 236 either managed conservatively or surgical and observed in Intensive care unit were study population. Prognosis was assessed with Glasgow Outcome Score (GOS) on or before (if patient expired before 30 days) 30 post admission day. Age, GCS, CT findings, Pupils were compared with GOS to find probable predictors of prognosis. GOS of less than 4 was regarded as poor prognosis. Categorical variables like GCS, pupils, CT findings were presented in the form of frequency (percentage) whereas continuous variables like age were presented in the form of mean ± SD and median (range). Association between GOS and probable prognostic indictors was seen by chi square test.Results: Out of 236 patients, 188 were male and 48 were female. Mean ± SD age of patient was 32.8 ± 14.6 years. Age group 15 – 45 years had maximum number of patients. Road traffic accident was major cause of severe head injury and majority had GCS 3 after resuscitation. More than half of the patient had bilaterally reactive pupils, 10% patient had post traumatic fits and half of the patients had features of base of skull fracture. 208 (8%) patient had abnormal CT findings. 30% patient on CT scan had closed cisterns and half of the patients has midline shift of 1.5 – 3 mm. More than 35% cases had surgical lesions over CT scan. Patients with age group < 15 years, GCS < 4, with closed cisterns, with surgical lesions and with midline shift of more than 3 mm had 30 day GOS < 4, which is regarded as poor prognostic marker.Conclusion: Prognosis in patient with severe head injury is determined by age, presenting post resuscitation GCS, mode of injury, CT findings and surgical lesions