No abstract

Introduction: The anterior cervical decompression and fusion (ACDF)procedures, especially in cases requiring decompression of two or more levels. Routine use for the treatment of cervical spondylosis has caused plate design to change signicantly in recent years. Aim: To estimate the incidence of sub axial cervical trauma patients admitted in the Neurosurgery wards of the institute. To study the therapeutic outcome after management of the subaxial cervical trauma cases by Anterior cervical decompression (discectomy/corpectomy) with graft or cage and dynamic plate xation, posterior lateral mass screw-rod xation, bidirectional single stage combined approach techniques. To compare anterior dynamic plate graft xation with the posterior lateral mass screw rod xation in cases that could be managed by any single approach. Material and methods: This non randomized prospective observational study was conducted in the Department of Neurosurgery, Mahatma Gandhi Medical College & Hospital, Jaipurfrom April 2018 to December 2019. All diagnosed cases of subaxial cervical spine attending and being admitted to our institute during the study period and treated by anterior cervical decompression with dynamic plate xation, posterior lateral mass screw rod xation or combined technique were included in the study. Result:According to AO Spine Classication Type, 10(20.8%) patients had A2, 15(31.3%) patients had A3, 8(16.7%) patients had A4, 1(2.1%) patient had B2, 13(27.1%) patients had C and 1(2.1%) patient had C,F4. It was found that in Non Severe group, 6(31.6%) patients had A3type in AO Spine Classication Type and in severe group 9(31.0%) patients had A3type in AO Spine Classication Type. In Non Severe group, 4(21.1%) patients had C type in AO Spine Classication Type and in Severe group 9(31.0%) patients had C type in AO Spine Classication Type. The association between AO Spine Classication Type vs ASIAImpairment Scale Group was not statically signicant (p=0.6887). Conclusion:In ASIA IMPAIRMENT SCALE GROUP, 5 SLICS1 was higher [6(31.6%)] in Non Severe group and 8 SLICS1 was higher [9(31.0%)] in Severe group which was not statically signicant (p=0.4820).The mean EQ5D post op at 6month of Non Severe (ASIA IMPAIRMENTSCALE) patients was higher than the Severe group of patients which wasstatically signicant (p=0.0442).

Introduction: This study proposes to compare the use of the low pressure pneumoperitoneum/LPLC (< 9 mm Hg) with the use of standard pressure pneumoperitoneum/SPLC (14 mm Hg) in patients undergoing laparoscopic cholecystectomy in a prospective randomized manner in an attempt to lower the impact of pneumoperitoneum on human physiology. Method and Materials: The study was carried out with a sample size of 50 patients randomised into two groups, one with 25 patients-SPLC while the other group with 25 patients LPLC. To compare post-operative pain incidence of shoulder tip pain, average operation duration, need of additional analgesia post-operatively, duration of hospital stay, change in Pulse rate, SBP & DBP in both groups. Result: Incidence and intensity of post-operative pain, postoperative pain referred to the tip of the right shoulder were significantly lower in LPLC group compare with SPLC group. The average change in SBP in patients who underwent LPLC was an increase of 0.83 ± 8.66 mm Hg and in SPLC group was an increase of 0.91 ± 14.67 mm Hg. Average change in DBP in patients who underwent LPLC was increase of 1.75 ± 8.33 mm Hg and in SPLC group was an increase of 2.64 ± 8.34 mm Hg and in LPLC group was a decrease of 0.8 ± 12.01 beats per minute and in SPLC group was an increase of 1.8 ± 5.33 beats per minute. The average change in SBP, DBP & heart rate in patients who underwent LPLC & SPLC was not statistically significant. Average hospital stay for LPLC group are 1.92 days and for SPLC group its 2.48 days. Conclusion: An uncomplicated gall stone disease can be treated by low pressure laparoscopic cholecystectomy with reasonable safety by an experienced surgeon. It is significantly advantageous in terms of post-operative pain, use of analgesics, less shoulder tip pain and hospital stay.