The Current State of Neurosurgery in Afghanistan.

Background: Afghanistan has suffered through conflicts that have detrimentally impacted its health care systems. The countries' neurosurgeons have worked through wars and political upheavals to build solid practices and handle large caseloads with minimal supplies and almost no modern tools. Understanding the current state of neurosurgery in Afghanistan and the challenges faced by Afghan physicians and patients is critical to improving the country's healthcare capacity.

Utilising a Real-Time Continuous Glucose Monitor as Part of a Low Glycaemic Index and Load Diet and Determining Its Effect on Improving Dietary Intake, Body Composition and Metabolic Parameters of Overweight and Obese Young Adults: A Randomised Controlled Trial.

A randomised controlled trial to measure the effects of integrating real-time continuous glucose monitor (rtCGM) into a low glycaemic index (GI) and glycaemic load (GL) dietary intervention on dietary intake, body composition and specific metabolic parameters was carried out. A total of 40 overweight young adults [(means ± SD) age: 26.4 ± 5.

Association between triage level and outcomes at Médecins Sans Frontières trauma hospital in Kunduz, Afghanistan, 2015.

Background: Five million people die annually due to injuries; an increasing part is due to armed conflict in low-income and middle-income countries, demanding resolute emergency trauma care. In Afghanistan, a low-income country that has experienced conflict for over 35 years, conflict related trauma is a significant public health problem. To address this, the non-governmental organisation Médecins Sans Frontières (MSF) set up a trauma centre in Kunduz (Kunduz Trauma Centre (KTC)).

Acute Spontaneous Cervical Spinal Epidural Haematoma a Very Rare Presentation Mimicking of Carotid Dissection during Sleep.

Acute spontaneous spinal epidural hematoma without any identified etiology is a rare phenomenon and an uncommon cause of acute spinal cord compression. We report a case of acute spontaneous cervical spinal epidural hematoma, with sudden onset of acute neck pain and left-side body weakness during sleep which resembling of cervicle carotid dissection. The pain commenced suddenly, early in the morning while the patient was asleep.

Association Between Gender, Surgery and Mortality for Patients Treated at Médecins Sans Frontières Trauma Centre in Kunduz, Afghanistan.

Introduction: There is paucity of literature describing type of injury and care for females in conflicts. This study aimed to describe the injury pattern and outcome in terms of surgery and mortality for female patients presenting to Médecins Sans Frontières Trauma Centre in Kunduz, Afghanistan, and compare them with males.

Materials And Methods: This study retrospectively analysed patient data from 17,916 patients treated at the emergency department in Kunduz between January and September 2015, before its destruction by aerial bombing in October the same year.

Neuromuscular fatigue in prostate cancer patients undergoing radiation therapy.

Objective: To determine the etiology of fatigue in prostate cancer patients undergoing radiation therapy (RT).

Methods: Thirteen prescreened men (60 to 76 years in age, 58 to 130 kg in body weight) were evaluated for neuromuscular fatigue (NMF) of the tibialis anterior (TA) muscle, cardiopulmonary fatigue (CPF), and psychological-subjective fatigue (PSF) at 1 to 2 weeks before RT (Pre), at the end of 8 weeks of RT (RT), and at 5 to 6 weeks after completion of RT (Post).

Outcome Measures: For NMF, the TA muscle was fatigued by sustained isometric contraction at 80% of maximum voluntary contraction for 60 seconds on a force dynamometer.

Endplate dysfunction in healthy muscle following a period of disuse.

The objective of this study was to test the hypothesis that muscle disuse can result in abnormal neuromuscular transmission. Six healthy volunteers (2 females, mean age = 33 years) participated in the study. Cast immobilization of one leg, for a period of 4 weeks, was used as a model of disuse; the contralateral leg was used as a control.

Neuromuscular adaptations during 30 days of cast-immobilization and head-down bedrest.

Prolonged skeletal muscle disuse, during space flights and on Earth, produces distinct adaptive changes in the neuromuscular system of human subjects. There is a significant decline in muscle mass and strength, exercise capacity, fatigue resistance, integrated EMG (IEMG) output and time-dependent alterations in the behavior of Hoffman (H) and deep tendon reflexes. The objective of this study was to examine the changes in excitability of segmental motoneuronal network and its influence upon gastrocnemius-soleus (G-S) function in healthy male and female subjects, who underwent either 6 degrees head-down bedrest (HDB) or unilateral cast-immobilization (CIM) for a period of 30 days.

Electrical impedance measurements in the arm and the leg during a thirty day bed rest study.

The need to detect, follow and understand the effects of gravity on body fluid distribution is a constant stimulus to the quest for new techniques in this area of research. One of these techniques is electrical bioimpedance spectroscopy (BIS). Although not new, this is a technique whose applications to biomedical research are fairly recent.

Evaluation of muscle injury using magnetic resonance imaging.

The objective of this study was to investigate spin echo T2 relaxation time changes in thigh muscles after intense eccentric exercise in healthy men. Spin echo and calculated T2 relaxation time images of the thighs were obtained on several occasions after exercise of one limb; the contralateral limb served as control. Muscle damage was verified by elevated levels of serum creatine kinase (CK).

Changes in nerve conduction and Pi/PCr ratio during denervation-reinnervation of the gastrocsoleus muscles of rats.

The purpose of this investigation was to study the changes in nerve conduction and phosphate metabolites of the gastrocsoleus muscles of rats during denervation-reinnervation. Sixteen male Sprague-Dawley rats underwent unilateral crush-denervation of the left sciatic nerves at the sciatic notch. Six rats were used for measurement of motor conduction latency and action potential amplitude of the gastrocsoleus muscle by stimulating the sciatic nerve at one, two and eight weeks after nerve crush.

Postpoliomyelitis muscle weakness: a prospective study of quadriceps strength.

The objective of this study was to evaluate the presence of progressive postpoliomyelitis muscle weakness (PPMW) in affected individuals 20 to 40 years after the initial polio infection. Over a three-year period, the isometric and isokinetic strength of the quadriceps femoris muscle was studied in seven symptomatic patients with previous poliomyelitis (mean = 38.3 years from infection) to determine if quadriceps strength decreased during the three years.

Spontaneous electromyographic potentials in chronic spinal cord injured patients: relation to spasticity and length of nerve.

Nine patients with complete cervical spinal cord injury (SCI) had their vastus medialis, tibialis anterior, and gastrocnemius muscles evaluated with an electromyographic (EMG) examination in the acute (four to eight weeks) and chronic (more than one year) phases. The hypothesis that spontaneous EMG activity changes with time was assessed. During the chronic phase evaluation, a conduction study was performed to rule out peripheral nerve damage, and the amount of reflex activity was assessed on a scale of 0 to 5 (0 = areflexia; 5 = greater than 5 beats of clonus) to estimate the amount of spasticity.

Recovery of strength at the zone of injury in motor complete and motor incomplete cervical spinal cord injured patients.

This study compared the time of recovery at the zone of injury between motor complete (Frankel A and B) and motor incomplete (Frankel C and D) cervical spinal cord injured patients for the biceps (C5), extensor carpi radialis (C6), and triceps (C7) muscles. Manual muscle testing was performed initially three to seven days postinjury, then weekly for four weeks, and then monthly for six months. Subjects between the ages of 15 and 70 years with C4, C5, C6, or C7 neurologic levels were classified according to whether their selected muscle was greater than 0/5 and less than 3/5 grade (n = 32) or greater than or equal to 3/5 grade (n = 28) at initial evaluation.

Deep vein thrombosis: prophylaxis in acute spinal cord injured patients.

The purpose of this prospective, randomized study was to evaluate the efficacy of low-dose heparin, alone or in combination with electric stimulation, in the prevention of deep vein thrombosis (DVT) in C2 to T11 motor complete and incomplete-preserved motor, nonfunctional spinal cord injured patients. The tibialis anterior and gastrocnemius-soleus muscle groups were stimulated bilaterally, using 50 microsecond pulses given at 10Hz with a four-second "on" and an eight-second "off" cycle for 23 hours daily over a 28-day period. Forty-eight patients, less than two weeks after injury, were randomly assigned to saline placebo (n = 17), low-dose heparin (5,000U, subcutaneous every eight hours) (n = 16), and low-dose heparin plus electric stimulation (n = 15).

Overwork-induced axonal hypertrophy in the soleus nerve of the rat.

Effect of overwork, induced by synergistic tenotomy (bilateral tenotomy of the gastrocnemius and the plantaris muscles) of the soleus muscle, was evaluated on areas of the large myelinated axons (LMA) (greater than 19.5 micron 2), in the soleus nerve (the tibial nerve branch innervating the soleus muscle) of the rat. Three lots (n = 12-16) of young adult male (body weight of 275 to 325 g), Sprague-Dawley rats were used.

Muscle atrophy in rheumatoid arthritis.

The purpose of this paper is to describe some research opportunities in the area of muscle atrophy secondary to arthritis. Future research should utilize quantitative methods of evaluating muscle atrophy such as computerized tomography or ultrasonography. The gross muscle atrophy should be further characterized by muscle fiber type measurements.

Effects of 6-mercaptopurine on developing muscle cells in vitro.

Treating differentiating muscle cells in vitro with 6-MP has resulted in a number of myopathic changes, some of which resemble the changes seen in 6-MP-treated neonatal rats. 6-MP treatment was cytotoxic to myotubes, but not myoblasts. The degenerative changes observed in 6-MP-treated myotubes were quite similar to those described in the neonatal rats by Alleva and his colleagues (1981).

Muscle atrophy and histopathology of the soleus in 6-mercaptopurine-treated rats.

In this study, male and female Sprague-Dawley rats were treated neonatally with 6-MP-treatment (2 mg/kg s/c, between 2 and 22 days after birth) and evaluated at six months of age. Compared to the normal controls, the 6-MP-treated male and female rats showed similar sciatic nerve conduction to the soleus. However, there was a significant muscle atrophy (57-60%, P less than 0.

Capillary fiber ratio and electrolyte content of compensatory hypertrophied rat soleus.

Capillary-to-fiber ratio and the content (mu moles/g muscle) of Na, K, Mg, Ca and Zn was measured in compensatory hypertrophied (CH) soleus muscles of adult Sprague-Dawley rats. The soleus hypertrophy was induced by unilateral tenotomy of the gastrocnemius and the plantaris muscles. Seven days after synergistic tenotomy the compensatory hypertrophied Soleus muscles showed no difference in the capillary-fiber ratio, Sr-extractable calcium ([Ca]Ext.

Overwork effect on partially denervated rat soleus muscle.

The purpose of this study was to assess the effect of overwork induced by synergistic tenotomy on the muscle weight (MW) and isometric tetanic tension (Po) of the partially denervated rat soleus muscle. Forty-nine young adult male Sprague-Dawley rats were divided into six groups (n = 5 to 9): normal control (N), normal synergistically tenotomized (N-ST), L4 denervated control (L4), L4 denervated synergistically tenotomized (L4-ST), L5 denervated control (L5), and L5 denervated synergistically tenotomized (L5-ST). Bilateral L4 or L5 root transections produced partial denervation.

Electrical stimulation of sciatic nerve of rats after partial denervation of soleus muscle.

The purpose of this study was to determine the effect of electrical stimulation of the sciatic nerve on the recovery of the weight and tension of partially denervated rat soleus muscle. Electrodes were implanted unilaterally adjacent to the sciatic nerve in 30 adult female Wistar rats. Fifteen rats underwent bilateral partial nerve section (PNS) of the sciatic nerve to stimulate the plantar flexors.

Muscle atrophy and histopathology of the soleus in 6-mercaptopurine-treated rats.

This study was conducted to examine the histochemical changes occurring due to neonatal 6-mercaptopurine (6-MP) treatment (2 mg/kg, sc, between 2 and 22 days after birth) in the slow-twitch muscle (soleus) of adult male and female rats. At 6 months of age, the control and the 6-MP-treated rats were evaluated for the sciatic nerve conduction to the soleus and for the soleus atrophy and histopathology of the type I (slow-twitch) and type II (fast-twitch) muscle fibers. Compared to the normal controls, the 6-MP-treated male and female rats showed similar sciatic nerve conduction to the soleus.