Shamim, Muhammad Shahzad

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eCommons@AKU

eCommons@AKU Section of Neurosurgery Department of Surgery 1-2016 Response to the comments: "Prospective case control evaluation of epidural midazolam for improving pain and ambulation after microdiscectomy" Muhammad Shahzad Shamim Follow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg  Part of the Neurology Commons, Neurosurgery Commons, and the Surgery Commons Vol. 66, No. 1, January 2016121We thank the author for his noteworthy comments on ourpaper.1 It is not unusual for two group of researchers todiffer in their categorization of a study design, and indeedthere appear overlaps if one isn't careful in designing aparticular study. In retrospect, we do see why it is felt thatour published paper may be categorized as anobservational study, but I would like to point out that acase control study is categorised on the basis of presenceor absence of exposure, rather than outcome.We also read with interest the second and thirdsuggestions made by the author, especially the pointwhere he mentions the presence of confounders. Weagree that the small sample size is a definite limitation ofour study, which not only limits drawing conclusions fromit, but at the same time, overestimates the significance ofp-value. We however disagree that the confounders havenot been looked at. The two study groups werecomparable both in terms of presence (or absence) of co-morbidities, and also the disease severity, as partlymentioned in the methodology. Other confounders weresimilarly looked at. Under these circumstances, apropensity score approach did not seem necessary. Thedetails of the methodology may have been omitted dueto editorial requirements of the journal. Controlling theconfounders was perhaps easier to do, given the smallsample size, which brings us to the same limitation of thestudy that is the sample size. We cannot emphasizeenough the importance of bigger data, which naturallywould have sorted out these problems. We cannot arguewith the statement that randomisation would have beenmore reasonable.We once again thank the author for his comments andhope the response clarifies some of the queries.Reference1. Shamim MS, Enam SA, Tahir MZ, Khan M. Prospective case controlevaluation of epidural midazolam for improving pain andambulation after microdiscectomy. J PakMed Assoc 2012; 62: 561-5.LETTER TO THE EDITORResponse to the Comments: “Prospective case control evaluation of epiduralmidazolam for improving pain and ambulation after microdiscectomy”Muhammad Shahzad ShamimSection of Neurosurgery, Department of Surgery, Aga Khan University Hospital,Karachi.Correspondence: Email address: shahzad.shamim@aku.edu

Response to the comments:  Prospective case control evaluation of epidural midazolam for improving pain and ambulation after microdiscectomy

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Response to the comments: Prospective case control evaluation of epidural midazolam for improving pain and ambulation after microdiscectomy

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