Evaluation of Ulnar Neuropathy on Hemodialysis Patients.

Evaluation of Ulnar neuropathy on hemodialysis patients.

J Res Med Sci. 2012 Oct; 17(10): 905-10
Vahdatpour B, Maghroori R, Mortazavi M, Khosrawi S

Ulnar nerve entrapment at the elbow is the second most common upper extremity nerve involvement after median nerve involvement at the wrist or carpal tunnel syndrome (CTS) considering the frequency of occurrence in the upper limb with variable causes. Hemodialysis, because of elbow positioning during dialysis, upper extremity vascular-access, and underlying disease is one cause of ulnar entrapment. This study considers evaluating the effect of elbow positioning on ulnar involvement prevalence during dialysis.This cross-sectional study started in June 2011 and completed in December 2011. The patients receiving dialysis with at least one symptom or sign of ulnar nerve involvement underwent nerve conduction studies. Electromyography testing (EMG) performed to confirm the ulnar neuropathy. To review the ulnar nerve, patients must be in supine position with arm in 90° abduction and elbow in 135° flexion. We stimulated the ulnar nerve at three different points, including 6 cm above and 4 cm below the elbow and over the wrist. According to the electrophysiological data, the intensity of nerve entrapment and possibility of associated polyneuropathy determined.Clinically and electrodiagnostically, evidence confirmed that ulnar neuropathy was present in 11 (27.5%) of 40 hemodialysis patients and in 10 (25%) of 40 peritoneal patients (P value: 0.83). Also, the prevalence of median neuropathy in hemodialysis and peritoneal dialysis patients was 14 (35%) and 10 (25%), respectively (P value: 0.33).The frequency of median and ulnar neuropathy in hemodialysis patients is more than peritoneal dialysis, but this different is not significant. In addition, comparing sitting position with prolonged elbow flexion and supine position with elbow extension during hemodialysis, recommended doing hemodialysis in later position with using an elbow pad. HubMed – rehab

A pilot study of mental health and quality-of-life of caregivers of children with cleft lip/palate in India.

Indian J Psychiatry. 2013 Apr; 55(2): 167-9
Gowda MR, Pai NB, Vella SL

There has been insufficient and contradictory research to date on the impacts of caring for a child with cleft lip/palate. Therefore this pilot study sought to investigate the mental health and quality of life of primary caregivers of children with cleft lip/palate.Seventy-nine primary caregivers of children with cleft lip/palate awaiting a surgical procedure in India completed questionnaires to measure their mental health, quality of life, and demographic variables.The results indicated that half of the sample suffered from poor mental health and a reduced quality of life. Overall perceptions of quality of life were significantly associated with the age of the child requiring care and the contact hours per day spent with the child.It is apparent that caregivers for this population do suffer from a reduced quality of life and poorer mental health. This is especially relevant for older caregivers and those with greater caring responsibilities. HubMed – rehab

Spinal anaesthesia in poliomyelitis patients with scoliotic spine: A case control study.

Indian J Anaesth. 2013 Mar; 57(2): 145-9
Kumari BG, Samantaray A, Kumar VA, Durga P, Jagadesh G

There is limited data to predict the course of sub-arachnoid block in poliomyelitis patients with scoliotic spine. So we intended to study the course of intrathecal anaesthesia in these patients in comparison to patients with normal spine using 0.5% bupivacaine (heavy).In this prospective observational study, 41 poliomyelitic patients scheduled for lower limb corrective surgeries under spinal anaesthesia were enrolled. Patients were studied in two groups (Scolotic spine, n=20; Normal spine, n=21). All patients were injected 2 ml of 0.5% bupivacaine heavy intrathecally in the sitting position. The extent of block, bilateral spread, regression of sensory block and motor block were recorded. Demographic data were analysed using the unpaired t test or the chi square test as applicable. Block characteristics were analysed using the Mann Whitney U test.There was statistically significant difference in bilateral spread of sensory block in between the groups. However, there was no significant difference in the maximum extent of the sensory block and the time taken for two segment regression of sensory block. There was no significant difference in time taken to reach complete motor block and for complete recovery from motor block to its preoperative value.Bilateral symmetrical spread of local anaesthetics through intrathecal route cannot be predicted accurately in patients with scoliotic spine. Spinal anaesthesia can be safely administered in poliomyelitis patients with scoliosis with less adverse effects. HubMed – rehab