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  • ISSN: 2334-2307
    Volume 8, Issue 1
    Original Article
    Gunnar Lindhe, Carin Bergfeldt and Ake Seiger*
    Aim: To highlight the self- perceived impact on everyday life of feeling cold in persons with acquired tetraplegia.
    Introduction: Spinal cord injury results in a multitude of functional deficits below the level of the injury. Most obvious is the more or less complete paralysis and loss of sensation. Less visible but of significant importance is the loss of temperature control when the injury is higher than thoracic level 6. This much neglected daily problem is subject to this study, where tetraplegic spinal cord injury individuals were informants.
    Design: Exploratory design with qualitative and semi- quantitative approach using a web-based questionnaire, reporting on self-perceived discomfort due to disturbed temperature regulation in persons with cervical spinal cord injury. Analyses were carried out by descriptive statistics and content analysis.
    Results: Results indicate that the functional disturbance almost invariably impacts on everyday life by feeling cold, coping strategies are mandatory, stake holders are either ignorant or at least inattentive to the problem, and that there is room for significant improvements in treatment programs for this target group.
    Conclusion: Persons with acquired tetraplegia report extensive impact on their everyday life by almost constantly feeling cold.
    Research Article
    Salim Hirani*
    Background: The localization of ulnar nerve entrapment across wrist (UNEAW) may be categorised in a number of ways utilising one of a range of presently available methods via nerve conduction study (NCS). A number of approaches as to how to confirm entrapment at the wrist have been described in the literature. There are number of research paper showing several different ways to confirm entrapment.
    The aim of this research is to establish, using the best available evidence, a clinically appropriate revision of the current UNEAW nerve conduction study, and to compare this with existing Neurophysiological procedure.
    The proposed revised research is based on more nuanced, descriptive categories, ranging from ulnar sensory branch in digit V, mid palm ulnar sensory entrapment, sensor-motor entrapment across wrist and involvement of dorsal ulnar cutaneous nerve (DUCN).
    Method: A total of 46 hands were included in this study. Data was collected based on the extensive and detailed description mentioned in different research papers. The tests were performed by a qualified clinical physiologist (Neurophysiology) using a Keypoint 9033A07 machine, used in line with departmental protocol (Ulnar nerve screening protocol1.1, 2020). All data was recorded numerically to ensure methodological reliability.
    Result: Of the 46 hands tested, the NCS showed that 21 hands had entrapment only in ulnar sensory branch at digit V, 16 hands showed entrapment below wrist (at the palm), 12 hands showed entrapment across wrist (Guyon’s Canal), 11 hands showed entrapment across elbow involving ulnar sensory branch as well, and only one hand showed sensory entrapment above wrist due to a local injury.
    Conclusion: The ulnar nerve entrapment at or below wrist could easily be missed. Lack of familiarity of the anatomical localization of ulnar sensory nerve could be misdiagnosed with entrapment across elbow. Nerve conduction study is necessary to diagnose the level of entrapment of ulnar nerve at or below wrist.
    Rachel Mascari, Alexandra Vezzeti, Christine Orofino, Amanda Byrd, David Hicklin, Cynthia Nichols, James Curtis, and Souvik Sen*
    Objectives: We investigated whether periodontal disease is associated with specific stroke subtype.
    Materials and Methods: This is a single-center cross-sectional study. Periodontal disease was assessed in stroke and transient ischemic attack patients. Strokes caused by large-artery atherosclerosis were classified as intracranial atherosclerosis or extracranial atherosclerosis as well as anterior or posterior circulation disease.
    Results: Consecutive patients (N=265) were enrolled (age 64 ± 12.8, 49% white, 46% black, and 56% male). A third (N=87) had moderately severe periodontal disease. Twenty percent (N=42) were strokes due to large-artery atherosclerosis. Large-artery strokes had a higher proportion of patients with periodontal disease than without periodontal disease (31% vs.16%, X2 p=0.01). There was also a higher proportion of patients with periodontal disease (12% vs. 5%) with stroke due to posterior circulation disease (crude odds ratio or OR 3.0, 95% CI 1.1-7.9, p=0.03), which persisted after adjustment for covariates (adjusted OR 3.1, 95% CI 1.04-9.1, p=0.004). Periodontal disease patients had a higher rate of large-artery stroke due to intracranial atherosclerosis compared to those without periodontal disease (20% vs. 8%; crude OR 2.6, 95% CI 1.3-5.6, p=0.01), and this association persisted after adjustment (adjusted OR 2.6, 95% CI 1.1-5.8, p=0.004).
    Conclusions: We report a higher proportion of stroke due to large-artery atherosclerosis in patients with periodontal disease compared to those without periodontal disease. We report an independent association between periodontal disease and intracranial atherosclerosis, as well as between periodontal disease and posterior circulation disease.
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