scholarly journals Retrospective study on the impact of ulnar nerve dislocation on the pathophysiology of ulnar neuropathy at the elbow

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6972 ◽  
Author(s):  
Seok Kang ◽  
Joon Shik Yoon ◽  
Seung Nam Yang ◽  
Hyuk Sung Choi

Introduction High resolution ultrasonography (US) has been used for diagnosis and evaluation of entrapment peripheral neuropathy. Ulnar neuropathy at the elbow (UNE) is the second most common focal entrapment neuropathy. The ulnar nerve tends to move to the anteromedial side and sometimes subluxates or dislocates over the medial epicondyle as the elbow is flexed. Dislocation of the ulnar nerve during elbow flexion may contribute to friction injury. We aimed to investigate the effects which the dislocation of ulnar nerve at the elbow could have on the electrophysiologic pathology of UNE. Materials We retrospectively reviewed 71 arms of UNE. The demographic data, electrodiagnosis findings and US findings of ulnar nerve were analyzed. We classified the electrodiagnosis findings of UNE into three pathologic types; demyelinating, sensory axonal loss, and mixed sensorimotor axonal loss. The arms were grouped into non-dislocation, partial dislocation, and complete dislocation groups according to the findings of nerve dislocation in US examination. We compared the electrodiagnosis findings, ulnar nerve cross sectional areas in US and electrodiagnosis pathology types among the groups. Results A total of 18 (25.3%) arms showed partial dislocation, and 15 (21.1%) arms showed complete dislocation of ulnar nerve in US. In the comparison of electrodiagnosis findings, the partial and complete dislocation groups showed significantly slower conduction velocities and lower amplitudes than non-dislocation group in motor conduction study. In the sensory conduction study, the conduction velocity was significantly slower in partial dislocation group and the amplitude was significantly lower in complete dislocation group than non-dislocation group. In the comparison of US findings, patients in partial and complete dislocation groups showed significantly larger cross sectional areas of the ulnar nerve. The comparison of electrodiagnosis pathologic types among the groups revealed that there were significantly larger proportions of the axonal loss (sensory axonal loss or mixed sensorimotor axonal loss) in partial and complete dislocation groups than non-dislocation group. Conclusion The ulnar nerve dislocation could influence on the more severe damage of the ulnar nerve in patients with UNE. It might be important to evaluate the dislocation of the ulnar nerve using US in diagnosing ulnar neuropathy for predicting the prognosis and determining the treatment direction of UNE.

2020 ◽  
Vol 5 (2) ◽  
pp. e24-e24
Author(s):  
Naim Sadat Kia ◽  
Mohammad Nassaji Zavareh ◽  
Elnaz Sarkheil ◽  
Elaheh Ghods

Introduction: Tuberculosis (TB) is one of the most common and lethal infectious diseases. Objectives: Due to the impact of biological, behavioral, socio-economic factors on the incidence of TB and the risks of the disease, we aimed to investigate the factors affecting TB in TB patients in Semnan. Patients and Methods: All patients with confirmed TB, who were referred to primary healthcare centers in Semnan for receiving medication, enrolled in the study (2012 to 2016). Data collected from clinical records and in-person interviews. The questionnaire consisted of two parts; the first part was demographic data and the other was related to the risk factors for TB. Results: The household crowding index was 1.86 ± 0.88. Most of patients (48.1%) were elderly (≥60 years old), female (59.7%), housewife (48.1%), had a pre-diploma education (63.6%), low-monthly income (62.3%) and married (63.6%). Around13.0% had diabetes. 20.8% drug abuser, 16.9% cigarettes and tobacco smokers, and 1.3% consumed alcoholic beverages. Besides, 40.3% were Afghans and 1.3% had the Pakistani nation. Conclusion: Identifying and controlling the social, geographical and biological factors affecting the incidence and mortality of TB in different regions can help to formulate appropriate strategies for achieving global goals. These factors differ among native and non-native population.


2021 ◽  
pp. 20210290
Author(s):  
Ankita Aggarwal ◽  
Chandan Jyoti Das ◽  
Neena Khanna ◽  
Raju Sharma ◽  
Deep Narayan Srivastava ◽  
...  

Objective: Early detection of peripheral neuropathy is extremely important as leprosy is one of the treatable causes of peripheral neuropathy. The study was undertaken to assess the role of diffusion tensor imaging (DTI) in ulnar neuropathy in leprosy patients. Methods: This was a case–control study including 38 patients (72 nerves) and 5 controls (10 nerves) done between January 2017 and June 2019. Skin biopsy proven cases of leprosy, having symptoms of ulnar neuropathy (proven on nerve conduction study) were included. MRI was performed on a 3 T MR system. Mean cross-sectional area, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of ulnar nerve at cubital tunnel were calculated. Additional ancillary findings and appearance of base sequences were evaluated. Results: Ulnar nerve showed thickening with altered T2W signal in all the affected nerves, having an average cross-sectional area of 0.26 cm2. Low FA with mean of 0.397 ± 0.19 and high ADC with mean of 1.28 ± 0.427 x 10 −3 mm2/s of ulnar nerve in retrocondylar groove was obtained. In the control group, mean cross-sectional area was 0.71cm2 with mean FA and ADC of 0.53 ± 0.088 and 1.03 ± 0.24 x 10 −3 mm2/s respectively. Statistically no significant difference was seen in diseased and control group. Cut-off to detect neuropathy for FA and ADC is 0.4835 and 1.1020 × 10 −3 mm2/s respectively. Conclusion: DTI though is challenging in peripheral nerves, however, is proving to be a powerful complementary tool for assessment of peripheral neuropathy. Our study validates its utility in infective neuropathies. Advances in knowledge: 1. DTI is a potential complementary tool for detection of peripheral neuropathies and can be incorporated in standard MR neurography protocol. 2. In leprosy-related ulnar neuropathy, altered signal intensity with thickening or abscess of the nerve is appreciated along with locoregional nodes and secondary denervation changes along with reduction of FA and rise in ADC value. 3. Best cut-offs obtained in our study for FA and ADC are 0.4835 and 1.1020 × 10 −3 mm2/s respectively.


2017 ◽  
Vol 16 (4) ◽  
pp. 251-254
Author(s):  
Kanokwan Kulprachakarn ◽  
Prakaydao Abkom ◽  
Orapin Pongtam ◽  
Sakaewan Ounjaijean ◽  
Paweena Thongkham ◽  
...  

The aim of this study was to investigate the impact of various food intake in patients with varicose veins. A cross-sectional study was conducted between December 2012 through November 2014. Patients at the outpatient department 101 at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand, who were older than > 18 years were invited to participate in this study. The severity of varicose veins was divided into 2 groups according to CEAP (clinical, etiological, anatomical, and pathophysiological) classification: mild type of venous disease (C0-C2) and severe type of venous disease (C3-C6). Patients were interviewed about their demographic data and frequency of meat consumption for varicose veins using Vein Consult Program (VCP). A total of 558 eligible outpatients were recruited for the study. Most patients were female (78.9%) and aged >50 years (47.1%). Seventeen out of 558 patients were diagnosed with high severity of venous disease (3.0%). Remarkably, significantly higher body weight (73.8 ± 13.9 vs 58.4 ± 11.2 kg, P = .000) and body mass index (28.8 ± 4.4 vs 23.3 ± 3.9 kg/m2, P = .000) was found in patients with severe types of venous disease compared with the mild group. Unexpectedly, only chicken intake demonstrated the different association with varicose veins ( P = .022). Patients with severe venous disease showed lower frequency of chicken consumption. The results suggested an association of chicken consumption with a reduced chance of developing varicose veins.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Paul Ratanasiripong ◽  
Takashi China ◽  
Nop T Ratanasiripong ◽  
Shiho Toyama

PurposeThe purpose of this paper is to describe the mental health issues among teachers globally and to investigate the significant factors that specifically impact the mental health of school teachers in Okinawa, Japan.Design/methodology/approachThis cross-sectional study examined depression, anxiety, stress, self-esteem and resiliency among 174 teachers from seven schools in Okinawa, Japan. The study questionnaire consisted of four parts, including demographic data, Depression, Anxiety, and Stress scale (DASS-42), Rosenberg Self-Esteem Scale (RSE), and Connor-Davidson Resiliency Scale (CD-RISC). Multiple regression analyses were performed to identify predictors of mental health variables.FindingsOf the 174 teachers, 111 were females (64%) and 60 were males (35%). Average age of participants was 41.65 (SD = 10.07). Average number of years being a teacher was 15.50 (SD = 9.88). There was a significant gender difference in the level of self-esteem. Significant differences in anxiety were found among varying grade levels taught. Regression analyses indicated that resiliency and self-esteem significantly predicted depression, anxiety and stress among school teachers in Okinawa.Originality/valueThis is the first study among school teachers in Okinawa that examined the impact of resiliency and self-esteem on their mental health. To reduce psychological distress common within the teaching profession, social and environmental support should be provided within the school to better foster the successful promotion of teacher resiliency and self-esteem.


2020 ◽  
Vol 17 (2) ◽  
pp. 64-69
Author(s):  
Svetlana Stojkov ◽  
Dušanka Krajnović

Objective. Continued Professional Development (CPD) is one of the most significant precursors to increased competency. Appropriate instruments and support are required for its implementation. This paper demonstrates the attitudes held by pharmacists on the impact of the competency framework on CPD, its acceptance among Serbian pharmacists and potential future application. Furthermore, the motivational impact of the competency framework on CPD as well as the relationship between certain demographic indicators and motivators of CPD are provided. Method. Research on the cross-sectional method throughout 2015-16 included pharmacists working in publicly-owned pharmacies. The survey was anonymous and voluntary. The questionnaires generated for this research contain demographic data on those surveyed and open-ended questions with multiple choice answers and applied a Likert-type scale. Statistical analysis was conducted by applying Microsoft Office 2003 and the Statistical Package for Social Sciences (SPSS) version 22. Results. Among the respondents, the female gender dominated, respondents who had not completed a speciality within their respective field, with an average age of 42 years, and an average of approx. 15 years of service. 26.12% of the respondents had prior experience with the competency framework. Most respondents were of the opinion that these instruments motivated them to actively manage their own PD, to set concrete PD objectives and to review their own competency. Over half intend to apply competency frameworks in future. The statistical Chi-square test indicates it is not possible to determine with certainty that there are differences in terms of motivation in managing PD and in PD goal setting between the groups of variables. Conclusion. The research indicates a positive attitude/opinion of pharmacists towards the competency framework and in recognising these instruments as supportive to CPD.


2016 ◽  
Vol 4 (4) ◽  
pp. 108-114
Author(s):  
M. Senthil

Living with epilepsy imposes great challenges on both patients and their family caregivers but most researchers only explored the impact on patients, with less attention given to family caregivers. Our study intended to explore the needs and problems of epilepsy family caregivers of epilepsy patients encountered during the caregiving process. The present study was an attempt to assess the relationship between Family interaction pattern, family burden schedule and Quality of life of the caregivers of individuals with epilepsy. This study was conducted at the Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi. It was a cross sectional study and purposive sampling was used. The present study was conducted among 60 caregivers of epilepsy, those who were willing to participate and those who have satisfied with inclusion and exclusion criteria have been included in the study. The socio demographic data sheet had been used for collecting socio demographic details of the caregivers of individuals with epilepsy. Family interaction pattern scale, family burden interview schedule and WHO Quality of life scale were applied on the caregivers of individuals with epilepsy. Statistical analysis was performed by using the SPSS programme 16.0 version. The result found that family interaction pattern has effect on family burden and quality of life. Likewise family burden has greater impact on quality of life. The study highlights the need for family interventional programs to address the specific issues related to family interaction, burden and quality of life of caregivers.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262325
Author(s):  
Nazish Imran ◽  
Fauzia Naz ◽  
Muhammad Imran Sharif ◽  
Sumbul Liaqat ◽  
Musarrat Riaz ◽  
...  

Background COVID-19 has posed unique challenges for adolescents in different dimensions of their life including education, home and social life, mental and physical health. Whether the impact is positive or negative, its significance on the overall shaping of adolescents’ lives cannot be overlooked. The aim of the present study was to explore impacts of the pandemic on the adolescents’ everyday lives in Pakistan. Methods Following ethical approval, this cross-sectional study was conducted through September to December, 2020 via an online survey on 842 adolescents with the mean age of 17.14 ± SD 1.48. Socio-demographic data and Epidemic Pandemic Impact Inventory-Adolescent Adaptation (EPII-A) was used to assess the multi-dimensional effects of the pandemic. Results Among the 842 participants, 84% were girls. Education emerged as the most negatively affected Pandemic domain (41.6–64.3%). Most of the adolescents (62.0–65.8%) had reported changes in responsibilities at home including increased time spent in helping family members. Besides, increase in workload of participants and their parents was prominent (41.8% & 47.6%). Social activities were mostly halted for approximately half (41–51%) of the participants. Increased screen time, decreased physical activity and sedentary lifestyle were reported by 52.7%, 46.3% and 40.7% respectively. 22.2–62.4% of the adolescents had a direct experience with quarantine, while 15.7% experienced death of a close friend or relative. Positive changes in their lives were endorsed by 30.5–62.4% respondents. Being male and older adolescents had significant association with negative impact across most domains (p<0.05). Conclusions Results have shown that COVID-19 exert significant multidimensional impacts on the physical, psycho-social, and home related domains of adolescents that are certainly more than what the previous researches has suggested.


Author(s):  
Farah Yousaf ◽  
Sadaf Mubeen ◽  
Amna Javaid ◽  
Muhammad Aamir Rafique ◽  
Hafiza Sobia Ramzan

Introduction: Atypical pneumonia known as coronavirus disease (COVID-19), which is caused by the SARS-CoV-2 virus, is highly infectious and is currently spreading rapidly around the globe. Objectives: The main objective of the study is to analyses the impact of COVID-19 on pregnancy outcomes among local population of Pakistan. Material and Methods: This cross sectional observational study was conducted in Lady Aitchison Hospital during September 2019 to August 2020. The data was collected through systematically designed questionnaire. Clinical characteristics, examination results, and treatment course were extracted from their medical records. For mothers, we collected socio demographic data, educational attainment, and occupation, maternal parity, medical history records, laboratory tests, and intensive care unit [ICU] admission. Results: The data was collected from 685 patients. The two groups of pregnant women were compared in terms of severe preeclampsia, gestational diabetes, premature rupture of membranes, fetal distress, maternal mortality, IUD, fecal staining of amniotic fluid, premature birth, neonatal asphyxia, Abruption or other compression sutures, and there was no significant difference Significance (all P >0.05); the proportion of IUD in the COVID-19 group was higher than that in the non COVID-19 group, and the difference between the two groups was statistically significant. Conclusion: It is concluded that those patients who visited the hospital during COVID-19 pandemics have high rate of IUD, placenta abruption and maternal death. Keywords: IUD., COVID-19


2018 ◽  
Vol 89 (6) ◽  
pp. A2.1-A2
Author(s):  
Luciana Pelosi ◽  
Dominic Ming Yin Tse ◽  
Eoin Mulroy ◽  
Andrew M Chancellor ◽  
Michael R Boland

IntroductionUlnar neuropathy with abnormal non-localising electrophysiology (NL-UN) is often associated with significant disability that is difficult to manage due to the absence of anatomically defining studies. We studied demographic, clinical and electrophysiological characteristics of NL-UN and used ultrasound in order to assist with classification and to examine the utility of ultrasound over and above the conventional electro-diagnostic approach.MethodNL-UNs were identified from 113 consecutive referrals to a single neurophysiologist with suspected ulnar neuropathy. All received systematic electro-diagnostic tests and ulnar nerve ultrasound. NL-UN severity was graded using clinical and electrophysiological scales.ResultsIn 64 of 113 referrals, an ulnar mononeuropathy was confirmed by electrophysiology. Sixteen of these 64 (25%) had NL-UN, predominantly males (14 out of 16 patients) with severe or moderately severe clinical and electrophysiological ratings in 81%. Ultrasound showed focal ulnar neuropathy at the elbow (UNE) in 13 out of 16, and diffuse ulnar nerve abnormality in three, and identified a likely or possible causative mechanism in 11 UNEs.ConclusionA quarter of ulnar neuropathies, as demonstrated by abnormal electrophysiology, were NL-UN, of heterogeneous aetiology; the majority were males with significant disability and axonal loss. Ultrasound had a significant role in localization and classification of NL-UN that facilitated management.


2021 ◽  
Vol 8 (5) ◽  
pp. 586-604
Author(s):  
Theophilus Ehidiamen OAMEN

Pharmaceutical sales representatives are a pivotal workforce in the healthcare system. Due to the global impact of COVID-19, the impact on the psyche and morale of the pharmaceutical sales workforce has to be examined. The primary objective of the study was to assess the possible impact of the COVID-19 pandemic on the psyche and productivity of the pharmaceutical sales workforce in Nigeria. A questionnaire-guided cross-sectional survey was used to collect data from pharmaceutical sales personnel across the six geopolitical zones in Nigeria using purposive sampling. The final sample was 225. Statistical analysis was done using SPSS 25. Descriptive statistics such as mean, standard deviation were used for demographic data. Cluster analysis was used to identify key demographic predictors of importance. X2 test was used to test the association between the sociodemographic characteristics of respondents and work-attributes. The difference of means was determined with a t-test. Highest and lowest-ranked work-attributes were information provider (3.62±1.36), and involvement in COVID screening activities (1.80±1.20). Average daily work hours before and during COVID-19 lockdown (2.16±0.04 vs. 1.88±0.11, p<0.05)) were affected. Average sales were significantly affected (3.15±0.48 vs. 1.35±0.36, p<0.0001). Psychological states of Anxiety and Increased burden have a medium to high impact on the psyche of respondents. The study revealed an association of both extremes of pessimism and optimism with regards to Frustration state of mind. Study suggests an overall negative impact on pharmaceutical sales representatives’ psyche and productivity. Attention to sales workforce welfare is required to safeguard medicine supply.


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