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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
Sat Jun 26 2021
Journal Name
Journal Of The College Of Education For Women
The Wisdom-Based Thinking and its Relationship to the Psychological Capital: طلل غالب علوان
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The present study aims to identify wisdom-based thinking and its relationship to psychological capital. It further aims to find out the differences in the level of wisdom-based thinking and psychological capital according to the variables of gender and specialization (scientific, humanities). To achieve this, the study has been conducted on a sample of (380) male and female students. The two scales, wisdom-based thinking and psychological capital are implemented to the sample after being constructed by the researcher and after ensuring their psychometric characteristics' suitability for the study's aims. Results concerning the first aim have shown that there is a significant relationship among students. The second aim has revealed that t

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Publication Date
Thu Nov 01 2012
Journal Name
Ijcsi International Journal Of Computer Science
Implementing a novel approach an convert audio compression to text coding via hybrid technique
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Compression is the reduction in size of data in order to save space or transmission time. For data transmission, compression can be performed on just the data content or on the entire transmission unit (including header data) depending on a number of factors. In this study, we considered the application of an audio compression method by using text coding where audio compression represented via convert audio file to text file for reducing the time to data transfer by communication channel. Approach: we proposed two coding methods are applied to optimizing the solution by using CFG. Results: we test our application by using 4-bit coding algorithm the results of this method show not satisfy then we proposed a new approach to compress audio fil

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Publication Date
Tue Jul 05 2022
Journal Name
Journal Of Pharmaceutical Care
Epidemiological and Clinical Factors Affecting the Response to Etanercept Among Patients with Rheumatoid Arthritis
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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Proposed Entropy Loss function and application to find Bayesian estimator for Exponential distribution parameter
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The aim of this paper to find Bayes estimator under new loss function assemble between symmetric and asymmetric loss functions, namely, proposed entropy loss function, where this function that merge between entropy loss function and the squared Log error Loss function, which is quite asymmetric in nature. then comparison a the Bayes estimators of exponential distribution under the proposed function, whoever, loss functions ingredient for the proposed function the using a standard mean square error (MSE) and Bias quantity (Mbias), where the generation of the random data using the simulation for estimate exponential distribution parameters different sample sizes (n=10,50,100) and (N=1000), taking initial

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Publication Date
Sun Oct 01 2023
Journal Name
Minerva Dental And Oral Science
Salivary interleukin-1β as a biomarker to differentiate between periodontal health, gingivitis, and periodontitis
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Publication Date
Tue May 16 2023
Journal Name
Journal Of Engineering
Experimental Investigation Utilizing Thermal Image Technique to the Heat Transfer Enhancement Using Oscillated Fins
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Heat transfer around a flat plate fin integrated with piezoelectric actuator used as oscillated fin in laminar flow has been studied experimentally utilizing thermal image camera. This study is performed
for fixed and oscillated single and triple fins. Different substrate-fin models have been tested, using fins of (35mm and 50mm) height, two sets of triple fins of (3mm and 6mm) spacing and three frequencies
applied to piezoelectric actuator (5, 30 and 50HZ). All tests are carried out for (0.5 m/s and 3m/s) in subsonic open type wind tunnel to evaluate temperature distribution, local and average Nusselt number (Nu) along the fin. It is observed, that the heat transfer enhancement with oscillation is significant compared to without o

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Publication Date
Fri Mar 01 2024
Journal Name
Annales Pharmaceutiques Françaises
Adopting video assignments as a tool to improve first-year pharmacy students class engagement
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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Comparison between the Local Polynomial Kernel and Penalized Spline to Estimating Varying Coefficient Model
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Analysis the economic and financial phenomena and other requires to build the appropriate model, which represents the causal relations between factors. The operation building of the model depends on Imaging conditions and factors surrounding an in mathematical formula and the Researchers target to build that formula appropriately. Classical linear regression models are an important statistical tool, but used in a limited way, where is assumed that the relationship between the variables illustrations and response variables identifiable. To expand the representation of relationships between variables that represent the phenomenon under discussion we used Varying Coefficient Models

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Engineering
Silica Fume Modified Cement-Based Mortar Exposed to High Temperatures: Residual Strengths and Microstructure
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Several previous investigations and studies utilized silica fume (SF) or (micro silica) particles as supplementary cementitious material added as a substitute to cement-based mortars and their effect on the overall properties, especially on physical properties, strength properties, and mechanical properties. This study investigated the impact of the inclusion of silica fume (SF) particles on the residual compressive strengths and microstructure properties of cement-based mortars exposed to severe conditions of elevated temperatures. The prepared specimens were tested and subjected to 25, 250, 450, 600, and 900 °C. Their residual compressive strengths and microstructure were evaluated and compared with control samples (C

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
Cognitive Beliefs and Their Relationship to Self-Organized Learning Strategies at the Preparatory Stage
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The study aims to identify the level of cognitive beliefs, as well as to identify the level of self-organized learning strategies among intermediate school students. The study also aims to identify the differences in the level of self-organized learning strategies among intermediate school students in term of gender, branch (scientific, literary). In order to achieve the research objectives, the researcher designed a scale to measure the cognitive beliefs. As for the scale of self-organized learning strategies, the researcher adopted a scale of (Pintrich et al. 1991), which was translated by (Izzat Abdelhamid, 1999) , For self-organized learning strategies, the sample consisted of (400) students from the research population, whic

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