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Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta
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Background:. Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial.

Objective: The aim of this study is to describe the outcome obtained in 61 adult patients with congenital TCS and no prior surgical treatment who underwent surgical untethering.

Methods: This prospective study was conducted on 61 adult patients who underwent surgical untethering for spina bifida occulta at four neurosurgical centers in Baghdad / Iraq  between March 2000 and January 2018. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded.

The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months (mean 20.9 months). Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes,

status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later.

Conclusions: Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As in children, we recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient’s general medical condition and risk posed by anesthesia.

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Publication Date
Fri Nov 01 2024
Journal Name
Heliyon
Strength and Deformation of Encased Concrete Columns by I- Section Steel and I- Section GFRP Subjected to Different Load Conditions
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Publication Date
Tue Oct 30 2018
Journal Name
Acs Omega
Catalytic Hydrogenation of <i>p</i>-Chloronitrobenzene to <i>p</i>-Chloroaniline Mediated by γ-Mo<sub>2</sub>N
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Promoting the production of industrially important aromatic chloroamines over transition-metal nitrides catalysts has emerged as a prominent theme in catalysis. This contribution provides an insight into the reduction mechanism of p-chloronitrobenzene (p-CNB) to p-chloroaniline (p-CAN) over the γ-Mo2N(111) surface by means of density functional theory calculations. The adsorption energies of various molecularly adsorbed modes of p-CNB were computed. Our findings display that, p-CNB prefers to be adsorbed over two distinct adsorption sites, namely, Mo-hollow face-centered cubic (fcc) and N-hollow hexagonal close-packed (hcp) sites with adsorption energies of −32.1 and −38.5 kcal/mol, respectively. We establish that the activation of nit

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Show fate to the people of Badr By Ibrahim ibn Hasan al-Kurani (1025-1101 AH): Study, investigate and comment
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It is the grace of God and his grace that he accepts repentance for his slaves, forgives their bad deeds in return for their misfortune, or offers them a good deed, but pardons many of them for free. Therefore, it is not long for God Almighty to forgive His mercy for many of His slaves and bring them to Paradise with no punishment or punishment, even if they have committed some sins, because of the multitude of their favorable navigational disadvantages, or even without gratitude thanks to him and him. With all this, some have overlooked the old and new on these things and amazed at the hadeeth ((God may have seen the people of the full moon and said do what you want, I have forgiven you)). Therefore, the scholars tried to answer some of

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Publication Date
Mon Mar 23 2020
Journal Name
Journal Of Engineering
Experimental and Numerical Investigation on the Performance of Straight-Bladed Vertical Axis Wind Turbine by Adding Cavities to it Structure
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As the prices of the fuel and power had fluctuated many times in the last decade and new policies appeared and signed by most of the world countries to eliminate global warming and environmental impact on the earth surface and humanity exciting, an urgent need appeared to develop the renewable energy harnessing technologies on the short-term and long-term and one of these promising technologies are the vertical axis wind turbines, and mostly the combined types. The purpose of the present work is to combine a cavity type Savonius with straight bladed Darrieus to eliminate the poor self-starting ability for Darrieus type and low performance for Savonius type and for this purpose, a three-bladed Darrieus type with symmetric

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Publication Date
Sun Jan 08 2023
Journal Name
International Journal Of Research In Social Sciences And Humanities
Evaluating Banking Performance According to the European Model of Institutional Excellence: Case Study at United Bank for Investment and Finance1
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The aim of the research is to identify the impact of the dimensions of the European Excellence Model in evaluating the performance of the bank of the research sample, as well as to interpret which dimensions are more important to the banks of the research sample. Based on the dimensions of this model, the United Bank for Investment and Finance has chosen a research community, and has met with officials of the United Bank for Investment and Finance at various administrative levels to measure the practices of excellence management in the European model, and the analytical approach has been the case study and the construction of the checklist as a tool to collect information. The research has reached the most important results There is a discr

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Publication Date
Fri Jul 01 2022
Journal Name
Operative Dentistry
Interfacial Bond Strength and Morphology of Sound and Caries-affected Dentin Surfaces Bonded to Two Resin-modified Glass Ionomer Cements
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SUMMARY<sec> <title>Objective

To evaluate the shear bond strength and interfacial morphology of sound and caries-affected dentin (CAD) bonded to two resin-modified glass ionomer cements (RMGICs) after 24 hours and two months of storage in simulated body fluid at 37°C.

Methods and Materials

Sixty-four permanent human mandibular first molars (32 sound and 32 with occlusal caries, following the International Caries Detection and Assessment System) were selected. Each prepared substrate (sound and CAD) was co

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Publication Date
Wed Jun 20 2018
Journal Name
Bulletin Of Iraq Natural History Museum
GENOTYPE VERSUS PHENOTYPE TO DETERMINE THE DEFINITIVE IDENTIFICATION OF THE GENERA CHLORELLA BEIJERINCK, 1890 (CHLORELLACEAE) AND COELASTRELLA CHODAT, 1922 (SCENDESMACEAE)
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Publication Date
Sun Jul 01 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
GENOTYPE VERSUS PHENOTYPE TO DETERMINE THE DEFINITIVE IDENTIFICATION OF THE GENERA CHLORELLA BEIJERINCK, 1890 (CHLORELLACEAE) AND COELASTRELLA CHODAT, 1922 (SCENDESMACEAE)
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    Conventional identification of three coccoid green algae isolates was attempted to characterize the studied algae morphologically under compound microscope, which demonstrated confusional phenomenal convergence; all were classified microscopically as the green alga Chlorella vulgaris Beijerinck, 1890.

 

    Phylogenetic studies were conducted to settle the argument about the phenotype by studying the genotype. Genotype the promising field in advance classification by using 18S rRNA and compared to GenBank database using to search the related sequences. The determined sequences showed high a similarity to the strains registered in GenBank.

 

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Publication Date
Mon Dec 01 2025
Journal Name
International Communications In Heat And Mass Transfer
Design optimization and performance analysis of a PCM-to-air heat exchanger with optimized fin configuration for building heating applications
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Publication Date
Tue Nov 30 2021
Journal Name
Research Journal Of Pharmacy And Technology
Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage
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Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient

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