Methods: Patients aged 65 years who had undergone either multilevel ACDF, LP, or PCF for the treatment of DCM were analyzed. Additional analysis was performed by standardizing the data for the American Society of Anesthesiologists classification scores and preoperative functional status. Results: A total of 23,129 patients were identified. Patients with ACDF were younger, more often female, and preoperatively healthier than those in the other two groups. The estimated postoperative mortality and morbidity, mean operation time, and length of hospital stay were the lowest for ACDF, second lowest for LP, and highest for PCF. The readmission and reoperation rates were comparable between ACDF and LP; however, both were significantly lower than PCF. Conclusions PCF is associated with the highest risk of mortality, morbidity, unplanned reoperation, and unplanned readmission in the short-term postoperative period in patients aged 65 years. In contrast, ACDF carries the lowest risk. However, some disease-specific factors may require posterior treatment. For these cases, LP should be included in the preoperative discussion when determining the ideal surgical approach for geriatric patients.

CLINICAL PROFILE OF HOSPITALISED IRRITABLE BOWEL SYNDROME PATIENTS IN INDIA ntroduction: Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal disorder. However due to poor health-seeking behaviour of the people and difficulties faced by medical professionals to diagnose IBS, it remains an under-diagnosed gastrointestinal disorder. Objectives: To study the risk factors, clinical presentation, and management of IBS among in-patients admitted at two tertiary care hospitals in Mangalore. Methods: Forty-one patients diagnosed with IBS based on ROME IV criteria between January 2017 to March 2021 were included. A semi-structured proforma was used to collect the required information. Results: The mean age at diagnosis among the patients was 44.6 ± 17.8 years. Twenty-four (58.5%) of them were females. Family history of IBS was present among five (12.2%) patients. IBS-M [18 (43.9%)] was the most common type. Alarming signs like blood and mucus in the stools were present each among eight (19.5%) patients. Weight loss was the most common extra-intestinal symptom [nine (21.9%)]. Mental health problems and psychosomatic disorders were present among seven (17.1%) and six (14.6%) patients, respectively. The most common drug used to treat constipation was Ispaghula husk [17 (41.5%)], and to treat diarrhoea was Loperamide [14 (34.1%)]. As many as 15 (36.6%) patients did not improve with treatment. None of the patients were put on non-pharmacological therapies. Conclusion: Holistic management of alarming signs such as blood and mucus in the stools and extra-intestinal symptoms like weight loss is required among IBS patients. Various mental health problems and psychosomatic disorders need to be screened and treated as a part of its management. Non-pharmacological therapies need to be also introduced to improve its treatment outcomes.

Although magnetic resonance imaging (MRI) is frequently used to assess the lumbar spine, there are few reports in the medical literature that have evaluated using MRI immediately following spinal surgery. Furthermore, descriptions of the subdural changes after lumbar spine surgery are also infrequent. In this paper, we present two cases with subdural change seen on MRI immediately after lumbar surgery. Both the patients had mild symptoms that resolved spontaneously, and the follow-up MRI scans showed resolution of the subdural changes. Subdural changes should be considered as one of the possible causes of unexpected symptoms in patients following lumbar spinal surgery.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Spine ; Subdural Space