MATERIAL & METHOD: 61 road traffic accidental death cases underwent both PMCT and conventional autopsy. The imaging findings were compared to the conventional autopsy findings.
RESULT: The sensitivity, specificity, PPV and NPV for liver injuries in PMCT was 71%, 82%, 68% and 85% while that of splenic injuries was 73%, 80%, 55% and 90% respectively. The accuracy of PMCT scan was 79% for both liver and splenic injuries. There is strong association between lower left ribs fracture and splenic injury (p=0.005) and significant association between positive liver and splenic PMCT finding and intraabdominal fatal injury (p=0.037).
CONCLUSION: In conclusion PMCT has high specificity and NPV for liver and splenic injuries; however the sensitivity and PPV are low. The overall accuracy is not high enough to enable PMCT to be used as a replacement for conventional autopsy; however it is a useful complementary examination and has potential to be used as decision making tool for selective internal autopsy.
METHODS: Published scientific literature pertaining to the reduction of FES-induced muscle fatigue was identified through searches of the following databases: Science Direct, Medline, IEEE Xplore, SpringerLink, PubMed and Nature, from the earliest returned record until June 2015. Titles and abstracts were screened to obtain 35 studies that met the inclusion criteria for this systematic review.
RESULTS: Following the evaluation of methodological quality (mean (SD), 50 (6) %) of the reviewed studies using the Downs and Black scale, the largest treatment effects reported to reduce muscle fatigue mainly investigated isometric contractions of limited functional and clinical relevance (n = 28). Some investigations (n = 13) lacked randomisation, while others were characterised by small sample sizes with low statistical power. Nevertheless, the clinical significance of emerging trends to improve fatigue-resistance during FES included (i) optimizing electrode positioning, (ii) fine-tuning of stimulation patterns and other FES parameters, (iii) adjustments to the mode and frequency of exercise training, and (iv) biofeedback-assisted FES-exercise to promote selective recruitment of fatigue-resistant motor units.
CONCLUSION: Although the need for further in-depth clinical trials (especially RCTs) was clearly warranted to establish external validity of outcomes, current evidence was sufficient to support the validity of certain techniques for rapid fatigue-reduction in order to promote FES therapy as an integral part of SCI rehabilitation. It is anticipated that this information will be valuable to clinicians and other allied health professionals administering FES as a treatment option in rehabilitation and aid the development of effective rehabilitation interventions.