Neurosciences
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Randomized Controlled Trial Comparative Study
Management options of chronic low back pain. A randomized blinded clinical trial.
To compare efficacies of 2 active programs in the management of chronic low back pain (CLBP). ⋯ Multidisciplinary rehabilitation improved functional indices and pain scale scores in group A compared with B. This would be an effective strategy in CLBP management.
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Lambert-Eaton myasthenic syndrome (LEMS) is frequently associated with malignancy, especially small cell lung cancer (SCLC). Here, we describe a patient with a 5-year history of cervical myelopathy who presented with recurrent limb weakness of her limbs and complained of recent progressive weakness. Following an examination that included electromyography, a chest CT scan, and a bronchofiberscopy examination with brushing biopsy, the patient was diagnosed with LEMS and SCLC. This case report highlights the ongoing need for clinicians to be observant for cases of LEMS, to consider both patient history and physical examination data, and to accurately obtain a differential diagnosis between LEMS and other diseases, which also cause weakness.
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Review Meta Analysis
Induced hypothermia to treat neonatal hypoxic-ischemic encephalopathy. Review of literature with meta-analysis and development of national protocol.
The efficacy of induced hypothermia to treat hypoxic-ischemic encephalopathy (HIE) in term infants has been evaluated in 6 multicenter randomized controlled trials. Meta-analysis of these trials shows that hypothermia in the first 6 hours after moderately severe HIE reduced the risk rate of death or neurological impairment at 18 months of age; risk ratio (RR): 0.81 (95% confidence interval [CI]: 0.71 to 0.93, p=0.002); risk difference -0.11 (95% CI: -0.18 to -0.04), with a number needed to treat of 9 (95% CI: 5-25). ⋯ We developed a national protocol using a simplified method of cooling. This protocol will hopefully lead to a widespread implementation of induced hypothermia in different settings within Saudi Arabia.