Schwannomas are benign tumours arising from neurilemmal cells which forms the myelin sheath of peripheral nerves. It usually occurs in the head, but may be found in the brachial plexus and sciatic nerve. Common peroneal nerve schwannoma are rare. We report a case of a middle age gentleman who presented with pain and swelling over the right popliteal fossa with associated right radicular pain of the anterolateral leg and weakness of ankle dorsiflexion. Examination revealed a 3x2 cm lump behind the posterolateral aspect of the right knee with positiveTinel’s sign upon tapping of the lump, sensory deficit over the anterolateral aspect of the leg and the ankle dorsiflexors had a muscle power of grade 3. Magnetic resonance imaging (MRI) of the right leg revealed a well circumscribed, oval lesion located along the pathway of the common peroneal nerve homogenously hypointense on T1-weighted images and heterogeneously hyperintense on T2 weighted images compared to the muscles. The lesion was not surpressed on fat suppression sequences. Intra-operatively, we noted that the schwannoma was in continuity with the common peroneal nerve. The patient underwent excision of the schwannoma. Post operatively, the pain reduced remarkably but patient suffers from numbness and right foot drop as a complication of the tumour. This case highlights the rarity of common peroneal nerve schwannoma which presents with neuropathic symptoms complicated with right foot drop.
The aim of this study was to assess the outcome of surgical treatment in displaced acetabular fractures in our local facilities. Previous studies reveal good outcome via open reduction method with achievement of congruent joint. We note that studies in this respect have not been conducted in our region. We retrospectively analyzed thirty patients with acetabular fractures who underwent open reduction and internal fixation. The data collection was performed over a 4-year period, from 2008 to 2011. The results showed 20 out of 30 patients (66.7%) had excellent/good results (Harris Hip Score equal or more than 80). Post operative complications were deep infection (6.7%), iatrogenic sciatic nerve injury (10.0%), avascular necrosis (16.7%), heterotopic ossificans (3.3%), degenerative changes in hip joint (43.3%) and loss of reduction (3.3%). In conclusion, surgical treatment of displaced acetabular fractures produces good functional outcome despite the complications.
This meta-analysis of published studies was conducted to determine the effectiveness of cardiac rehabilitation (CR) in terms of health-related quality of life (HRQoL) in post-coronary artery disease (CAD) patients in low- and middle-income countries (LMICs). Eighteen studies were identified from six countries (Malaysia, Iran, Brazil, Turkiye, China, and Pakistan) totalling 2,620 study participants with a mean age of 57.43 ± 7.9 years. Significantly higher mean physical (13.48, 95% CI: 7.75 to 19.21, p <0.001) and mental (11.52, 95% CI: 4.44 to 18.60, p <0.001) component scores were observed in the CR group compared to the usual group. The myocardial infarction- specific MacNew QLMI domains also showed significant mean differences (1.59, 95% CI: 0.97 to 2.21, p <0.001). This systematic review and meta-analysis showed significant improvements in physical and mental HRQoL in the CR group compared to the control group among post-CAD patients in LMIC. Furthermore, the myocardial infarction-specific MacNew QLMI global domain shows significant improvement in the CR group compared to the usual care group. Key Words: Acute coronary syndrome, Cardiac rehabilitation, Quality of life, Short-form 36, MacNew quality of life after myocardial infarction.