Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jan 2015
Review Meta AnalysisComparison of Total Disc Replacement with lumbar fusion: a meta-analysis of randomized controlled trials.
A meta-analysis was performed to evaluate whether a beneficial clinical effect of the Total Disc Replacement (TDR) over lumbar fusion for the treatment of patients with Degenerative Disc Disease (DDD). An electronic search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE from their inception to 2012 was completed, and we assessed risk bias and retrieved relevant data, and meta-analysis was performed, if appropriate. Oswestry Disability Index (ODI), Visual Analog Score (VAS), patient satisfaction or VAS patient satisfaction, narcotic use, overall success rate, reoperation rate, work status, "surgery again?", complications and radiographic outcomes were evaluated. ⋯ At 2 years, TDR was demonstrated to be more beneficial for patients compared to lumbar fusion in the following outcomes, including ODI scores (MD:-4.87, 95% CI: -7.77 to -1.97, p=0.001), patient satisfaction (OR:1.91, 95% CI: 1.27 to 2.86, p=0.002) and VAS patient satisfaction (MD:9.10, 95% CI: 3.20 to 14.99, p=0.002), the percentage of using narcotics (OR=0.54, 95%CI: 0.31 to 0.96, p=0.03), overall success rate (OR:1.68, 95% CI: 1.26 to 2.25, p=0.005), the rate of patients to chose the same surgical treatment again (OR:2.38, 95% CI: 1.72 to 3.28, p < 0.001), and complications (OR=0.50, 95%CI: 0.29 to 0.84, p=0.008). Other outcomes, including re-operation rate (OR:0.62, 95% CI: 0.36 to 1.06, p=0.08) and work status (OR=1.05, 95% CI: 0.75 to 1.47, p=0.80), were demonstrated to be no differences between the two groups. In a long-term of follow-up (2 years), TDR shows a significant superiority for the treatment of lumbar DDD compared with fusion.
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J Coll Physicians Surg Pak · Jan 2015
Endocrine correlates of polycystic ovary syndrome in Pakistani women.
To systematically examine the hormonal variations and their interactions in a local cohort of PCOS patients. ⋯ The gonadotrophins, LH to FSH ratio and androgens are dependable diagnostic parameters of PCOS. LH appears to be the most important in this regard, leading to hyperandrogenism.