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- Li, T, et al.
(author)
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Systemic hypothermia induced within 10 hours after birth improved neurological outcome in newborns with hypoxic-ischemic encephalopathy
- 2009
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In: Hospital Practice. - : Informa UK Limited. - 0018-5809 .- 2154-8331 .- 2377-1003. ; 37:1, s. 1-6
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Journal article (peer-reviewed)abstract
- Objective: To evaluate the efficacy of systemic hypothermia when applied within 10 hours after birth to neonates with hypoxic-ischemic encephalopathy (HIE). Study Design: Ninety-three term infants with moderate-to-severe HIE were randomly assigned to either systemic hypothermia (n = 46) or conventional treatment (n = 47). Hypothermia was induced within 10 hours after birth, decreasing rectal temperature to 33.5°C for 72 hours, followed by slow rewarming to 36.5°C. Neurodevelopmental outcome was assessed at 18 months old. The primary outcome was death or moderate-to-severe disability. Results: Outcome data were available for 82 infants. Death or moderate-to-severe disability occurred in 21 of 44 infants (47.7%) in the control group and in 7 of 38 infants (18.4%) in the hypothermia group (P = 0.01) at 18 months. The primary outcome was not different whether hypothermia was started within 6 hours or 6 to 10 hours after birth. Subgroup analysis suggested that systemic hypothermia improved long-term outcome only in infants with moderate HIE (P = 0.009), but not in those with severe HIE. No severe hypothermia-related adverse events were observed. Conclusion: Systemic hypothermia reduced the risk of disability in infants with moderate HIE, in accordance with earlier studies. Hypothermia was induced within 6 hours in most infants, but delaying the onset to 6 to 10 hours after birth did not negatively affect primary outcome. Further studies with a large number of patients are needed to confirm that delayed cooling is equally effective.
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- Farhan, Muhammad, et al.
(author)
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Pattern of neurosurgical cases and procedures in Gilgit Baltistan : two-year experience at a newly established neurosurgical department
- 2022
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In: Hospital Practice. - : Informa UK Limited. - 2154-8331 .- 2377-1003. ; 50:5, s. 368-372
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Journal article (peer-reviewed)abstract
- BackgroundIn Pakistan, there are a total of 160 neurosurgeons that constitute a ratio of one neurosurgeon for a 5.5 million population. Gilgit Baltistan being a backward region does not have a single tertiary care facility. A new department of neurosurgery was established at Regional Headquarter City Hospital (RHQ) Gilgit with only one neurosurgeon. This study aimed to determine which neurosurgical diagnoses are common and which surgical interventions were performed at RHQ.MethodsThis is a retrospective cross-sectional study conducted at Regional Headquarter Hospital (RHQ) Gilgit in which data of patients operated for neurosurgical diseases between January 2020 and January 2022 was collected from patient record books.ResultsOf the total of 223 patients, 148 (66.3%) were males and 75 (33.6%) were females. A total of 92(41.2%) belonged to the pediatric age group. The top most diagnosis included Neurotrauma (46.6%), NTDs (13.9%) and CSDH (10.3%) while the most routinely performed procedures were craniotomy & hematoma evacuation (22.9%), debridement & elevation of DSF (20.6%), and burrhole evacuation (13.9%). In the pediatric age group, the top diagnosis was Neurotrauma (43.5%), NTDs (32.6%), and Hydrocephalus (19.6%) while in adults, neurotrauma (48.9%) was the leading diagnosis followed by CSDH (17.6%). In the pediatric age group, repair of NTDs (32.6%) was the most frequently performed procedure.ConclusionThis study shows different kinds of neurosurgical cases but because of a lack of diagnostic and therapeutic facilities, very limited operations were performed and many cases were referred to metropolitan cities. The hospitals in the region need further up-gradation to cater to the presenting burden.
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