1.Results of Posterior Dislocation of Elbow Associated with Bony and Soft Tissue Injury
Neel M Bhavsar ; Jyotish G Patel ; Pankaj R Patel ; Jigar B Chhapan
Malaysian Orthopaedic Journal 2013;7(1):13-18
Elbow trauma is challenging to manage by virtue of its
complex articular structure and capsuloligamentous and
musculotendinous arrangements. We included 17 patients
with elbow dislocation and associated injuries in this study.
The study protocol included early elbow reduction and
planned fixation of the medial or lateral condyle, coronoid
and radial head. The sample was 73% male and 27% female
with mean duration follow-up of 8 months, and mean age of
37 years. The mean Mayo Elbow Performance Score was 96
points at conclusion of follow-up, indicating an excellent
result in 14 patients. Whenever the radial head was excised, we performed a strong transosseous ligamentous repair of the medial and lateral collateral ligaments. Fixation of the coronoid is essential for elbow stability. A small avulsed fragment can be fixed using an ACL jig. We found this technique very useful. Early planned intervention, stable fixation, and repair provide sufficient stability and enhance functional outcomes.
2.Psychiatric Comorbidities in Adults with DiGeorge Syndrome
Hiren PATEL ; Ramu VADUKAPURAM ; Zeeshan MANSURI ; Chintan TRIVEDI ; Kanwarjeet Singh BRAR ; Uzma BEG ; Jigar PATEL ; Aalamgeer IBRAHIM ; Muhammad Khalid ZAFAR
Clinical Psychopharmacology and Neuroscience 2022;20(3):498-503
Objective:
DiGeorge Syndrome (DGS) is a common multisystem disorder associated with deletions on chromosome 22q11.2. Our objective is to evaluate the psychiatric comorbidities and demographics of patients suffering from DGS in a nationally representative dataset on inpatient hospitalizations.
Methods:
The Nationwide Inpatient Sample for the year 2005−2017 was used for this study. Data on patients with DiGeorge syndrome were collected by using the International Classification of Diseases code. Univariate and multivariate logistic regression analysis was performed.
Results:
In our study, the average age was 30.4 years (n = 6,563), with 59.9% male, and 61.8% of patients were white. There was a high prevalence of mood disorders (24.7%) and anxiety disorders (16.4%), followed by schizophrenia and other psychotic condition (14.0%). In patients with mood disorders, 8% had Major Depressive Disorder, and 7% had bipolar depression. Overall composite of psychiatric comorbidities was present in 2,959 (45.1%) of patients. The mean length of stay was 6.58 days, and 77% of patients had routine discharge to home. In the adjusted analysis, the average length of stay was 8.6 days vs. 6.7 days (p < 0.001) in patients with and without psychiatry comorbidities.In comparison to routine discharge, patients with psychiatry comorbidities were more likely to be discharged to other healthcare facilities (odds ratio [OR]: 1.28, p < 0.001) and discharged against medical advice (OR: 3.45, p < 0.001).
Conclusion
Patients with DGS have worse outcomes with a higher rate of discharge to other healthcare facilities and a higher rate of being discharged against medical advice. Further large scale randomize studies are indicated.