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An Overview of Hydrocephalus and Shunts Used in The Clinical Management of Hydrocephalus

Hydrocephalus is a complex neurological condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain, leading to increased intracranial pressure. The clinical management of hydrocephalus often involves the surgical placement of a shunt system to divert CSF and restore normal fluid dynamics. This article provides a comprehensive overview of hydrocephalus, its etiology, clinical presentation, and various types of shunts used in its management. The outline of this report encompasses the principles of shunt surgery, indications for shunt placement and primary types of shunts used in the clinical management of hydrocephalus, including ventriculoperitoneal (VP), ventriculoatrial (VA), ventriculopleural (VPL), lumboperitoneal (LP) and ventriculo-subgaleal (VS) shunts. Additionally, some non-conventional shunts such as ventriculo-osseous, ventriculo renal, ventriculo gall bladder, intraventricular (Aqueductal stents) and long-tunnelled external ventricular drains are also discussed. The distinct features of each shunt type, its associated advantages, limitations and complications are also outlined together with a comparison between pressure vs flow regulated valves. An understanding of the different shunt types and their specific characteristics is essential for clinicians to make informed decisions in tailoring treatment to individual patients. This review offers a comprehensive understanding of shunt characteristics which we believe will empower clinicians to make informed decisions tailored to individual patients, ensuring effective CSF diversion and long-term management of hydrocephalus.

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Spontaneous Upper Cervical Cord Infarction: A Cohort of 13 Cases and Review of the Literature

The purpose of this study was to evaluate the risk factors, etiologies, clinical features, and functional outcomes of 13 consecutive patients who were admitted to our institution with a spontaneous upper cervical cord infarction (SUCI), a rare and devastating condition. A literature review of variables relevant to our case series was conducted. Methods: We revised all spinal cord stroke cases admitted between 2005 and 2020 to the Department of Neurology of the University Hospital Center “Mohammed V Military Teaching Hospital” of Rabat (Morocco). Data on the patient’s demography, clinical features, and functional outcomes of the upper cervical cord infarction patients were analyzed in Jamovi software for descriptive analysis. Results: Abdominal aortic aneurysm repair n=5(38.5%) and aortic dissection secondary to giant cell arteritis n=5(38.5%) were the possible etiology found. Nadir’s deficits were ASIA grade A in 4(30.8%) patients, grade B in 2(15.4%), C in 4(30.8%) and D in 3(23.1%). The Modified Rankin Scale at admission was mRS3 in 2 patients 15.4%, mRS4 in 7(53.8%), and mRS5 in 4(30.8%). At different stages of follow-up, three patients, 23.1% had died. In the other 10 patients, the residual deficits were ASIA grade B in (1/10) patients, D in (3/10), and E in (6/10). The recovery and degree of continued disability over time were mRS1 in (6/10) patients, and mRS2 in (4/10). Conclusion: The overall better outcome observed in this study can be related to the fact that more than half of the patients in our cohort had nadir ASIA C/D with mRS 3-4.

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Knowledge and Practices Regarding the Prevention Principles of COVID -19 Among Third Year Degree Nursing Students at a University Khomas Region, Namibia

Background: The rapid spread of SARS-CoV-2 is responsible for the global pandemic. Since the outbreak of COVID-12 began, necessary measurements and policies were provided to the public for prevention of the transmission of the disease. This measures and polies included: mandatory wearing of a mask in public, social distancing, regular hand sanitizing, and avoidance of overcrowded places etc. This study assessed the knowledge and practices regarding the prevention principles of covid-19 among third year degree nursing students at a University Khomas region, Namibia. Methods: A quantitative study was conducted on 77 study population and participants who were chosen using simple random sampling. The data was collected with the use of questionnaires. A pilot study was done on 5 participants to assess reliability of the data collection tool/questionnaire, or if there would be any changes that have to be made in the questionnaires and to note down time spent on answering the questionnaires. Data was analyzed with Microsoft excel version and descriptive analysis. The findings are presented in pie charts, bar graph and tables. Results: The findings showed that, most of the students 91% have good knowledge and practices regarding the prevention principles of OVID-19. Although the findings indicated overall good knowledge and good practices regarding applications of the preventive principles for COVID-19, the findings nevertheless indicated that 71% of the participants had average knowledge, 23,4% had poor knowledge while, 90% had average practices and 32% had poor practice regarding applications of the preventive principles for COVID-19. Out of the 77 participants, only 1% of the student know that COVI-19 is disease and the whole 99% don’t know which, apart from that poor knowledge, 25 participants from the 77, think getting vaccinated will prevent getting infected by COVID-19, but it only reduces getting infected. Conclusion: Some knowledge and practice gaps were identified about the students not having average or poor knowledge whether COVID-19 is a disease or virus and that getting vaccinated prevent one from getting infected or reduce the risk of getting infected. Apart from that, third year nursing degree students have good knowledge and practices on COVID-19 prevents

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