Hyperkyphosis is identified when kyphosis angle exceeds the normal ranges. In overall, hyperkyphosis upsurges with age, particularly after the age of 40. It arises as a consequence of multifactorial causes and is associated with increased health susceptibility. Separately from the penalties of typical aging, as declining muscle power and degenerative vicissitudes of the spine, additional influences lead to the growth of the kyphosis angle. Besides fractures, other adverse health outcomes associated with hyperkyphosis include worsening physical function, falls and earlier mortality. Given the growing older population and the high prevalence of age-related hyperkyphosis, better delineation of associated ill-health outcomes will help inform the development and testing of effective kyphosis managements. The sequence of handling with kyphosis start conventional and rolling to surgical interference as a previous option if the patient’s symptoms do not recover with conventional treatment or if the curving is too significant.

Gallstones cause biliary obstruction in about 5 out of 1000 people, whereas 10 to 15% of the adult population in the United States will have gallstones at some point in their lives. Gall stones, also known as cholelithiasis, are the precursor of choledocholithiasis, which occurs when gall stones pass through the cystic duct and lodge in the common hepatic ducts, causing an obstruction. Routine labs and some specialized labs are used in the diagnosis of biliary blockage. Severe complications can happen if left unchecked such as damaging the hepatic dysfunction, renal failure, nutritional deficiencies, bleeding problems, and infections. Treatment depends on the causing effect of bile duct obstruction. Sphincterotomy with lithotripsy, choledochotomy, choledochoduodenostomy, choledochojejunostomy, or cholecystectomy are the most used for large gall stones treatment. This review looks at the prevalence, etiology and management of the disease.

Moyamoya disease (MMD) is an isolated chronic, usually bilateral, vasculopathy disease of undetermined etiology. The clinical presentations of MMD include TIA, ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. Intra- and extra-cranial revascularization for the prevention of recurrence of bleeding in patients with hemorrhagic MMD is controversial. Surgical revascularization of MMD includes 3 types: Direct revascularization, indirect revascularization and combined revascularization. The surgical goal of cerebral revascularization is to prevent progression of symptomology, alleviate intracranial hemodynamic stress, and reduce the incidence of subsequent ischemic or hemorrhagic stroke. However, surgical treatments pose various complications due to the sudden increase in cerebral blood flow or hemodynamic changes caused by perioperative risk factors and anesthesia, such as HS, cerebral hemorrhage and cerebral infarction, bypass occlusion caused by distal vascular resistance, bypass occlusion caused by compression of the temporalis, and anastomotic aneurysm.