Extrinsic Causes Research Articles

Factors Associated with Postoperative Complications After Congenital Duodenal Obstruction Surgery: A Retrospective Study.

Background and Objectives: Duodenal atresia and stenosis are common causes of intestinal obstruction. Associated anomalies significantly influence early postoperative mortality, while postoperative complications impact long-term survival. Materials and Methods: Over a 13-year period from January 2010 to August 2023, a total of 74 infants and children with congenital duodenal obstruction were treated at "Grigore Alexandrescu" Children's Emergency Hospital and met the inclusion criteria. All patients diagnosed with duodenal obstruction (both instrinsic and extrinsic causes) were included. Analysed data included congenital anomalies, Apgar scores, birth weights, surgical techniques, and complications. Results: The associated anomalies included cardiac (n = 33), Down syndrome (n = 13), neurological (n = 11), pulmonary (n = 7), renal (n = 4), skeletal (n = 1), and gastrointestinal and hepatobiliopancreatic anomalies (n = 25). In total, 12 patients experienced perioperative ventilation problems. Early postoperative complications (within 30 days) occurred in 21 patients, while 6 had late postoperative complications (after 30 days). Among non-surgical complications, we noted ventilation problems, sepsis (n = 7), and pneumothorax (n = 1). Surgical complications included adhesive bowel obstruction (n = 7), incisional hernia (n = 3), peritonitis (n = 3), dysfunctional duodenoduodenostomy or duodenojejunostomy (n = 3), pneumoperitoneum (n = 5), enteric fistula (n = 3), and volvulus (n = 4). Conclusions: Surprisingly, this retrospective study revealed that an Apgar score below 8, along with neurological and pulmonary abnormalities, is associated with postoperative complications. Conversely, other congenital anomalies, low birth weight, and age at admission do not serve as prognostic factors.

User-resistance behaviours toward electronic health records: uncovering the determinants of perceived threats

ABSTRACT This study uncovers the determinants of perceived threats that have long been associated with resistance to healthcare information technology in general, and electronic health records in particular. Conceptualised as perceived dissatisfaction with outcomes and perceived helplessness over process, these threats are discussed from the perspective of the Psychological Reactance Theory. Study participants consisting of a diverse group of healthcare professionals were drawn from sample frame of health practices. Data from a sample of 217 participants were used to test the model. Using structural equation modeling, the model relationships were analyzed, and hypotheses were tested. The study results show that perceived threats to electronic health records are triggered by two types of factors: namely, intrinsic stimuli like self-efficacy and performance expectancy; and extrinsic causes such as social enabling effect and social influence. The implications of these findings are particularly useful to both research and practice. Managers and informaticians in both healthcare and non-healthcare settings will find the results both instructive and helpful in mitigating resistance. Theorists will be enriched by the insights from the antecedents of perceived threats to advance research.

Secondary Hypogammaglobulinemia

Secondary hypogammaglobulinemia (SHG) is characterized by reduced immunoglobulin levels due to extrinsic causes, such as a medication or an acquired disease process, resulting in decreased immunoglobulin production or increased immunoglobulin loss. Most published reports of SHG refer to IgG hypogammaglobulinemia and data on isolated IgA or IgM hypogammaglobulinemia is limited. The common causes of SHG include medications, hematological malignancies, and conditions associated with protein loss. Hypogammaglobulinemia can increase the risk of infection, morbidity and mortality, particularly in patients who may already be immunocompromised due to their associated condition or use of immunosuppressive therapies. With growing use of immunosuppressive or immunomodulatory treatments that affect B-cells, it is increasingly important to assess and monitor for SHG. Treatment of the underlying condition or removal of the extrinsic factor often results in resolution of the SHG. A subset of patients presenting with autoimmune or malignant conditions can have a primary immunodeficiency (PID) or primary immune regulatory disorder. It is therefore important to consider both primary and secondary causes when assessing hypogammaglobulinemia. This article will review these common causes and discuss an approach to assessment and management of SHG.

Single center experience with hourglass-like constriction neuropathy of suprascapular nerve.

Hourglass-like constriction (HGC) may occur in several peripheral nerves. However, data on the prognosis of motor weakness in patients with HGC of the suprascapular nerve (SSN) are limited compared with other nerves. Here, we aimed to describe the clinical and imaging features of HGC of the SSN. We retrospectively reviewed patients diagnosed with suprascapular neuropathy using magnetic resonance imaging (MRI) or electrodiagnostic studies over 16 years. After excluding extrinsic causes, patients with HGC of the SSN detected using MRI were included. Fourteen patients with HGC of the SSN were identified. MRI revealed that all HGCs were located between the origin of the SSN from the upper trunk of the brachial plexus and the suprascapular notch. Seven patients exhibited HGC precisely at the origin of the SSN from the brachial plexus. Four patients showed T2 hyperintensity of the SSN extending to the upper trunk of the brachial plexus or the extraforaminal cervical root. The initial treatments included observation (n = 1), steroid therapy (n = 12), suprascapular notch release (n = 1). Of the 12 patients with a sufficient follow-up period, nine fully recovered from motor weakness of the SSN with non-operative treatments. Six of the nine patients who recovered fully experienced their first clinical improvement more than 6 months after onset. Treatment strategies for HGC differ depending on the affected nerve. For HGC of the SSN, due to the high spontaneous recovery rate observed in our study, conservative management for at least 6 months should be initially considered.

Leptin gene expression in the brain is associated with the physiological onset of estivation in western sand lance Ammodytes japonicus.

Dormancy is an essential ecological characteristic for the survival of organisms that experience harsh environments. Although factors that initiate dormancy vary, suppression or cessation of feeding activities are common among taxa. To distinguish between extrinsic and intrinsic causes of metabolic reduction, we focused on estivation, which occurs in summer when the feeding activity is generally enhanced. Sand lances (genus Ammodytes) are a unique marine fish with a long estivation period from early summer to late autumn. In the present study, we aimed to elucidate the control mechanisms of estivation in western sand lance (A. japonicus), and firstly examined behavioral changes in 8 months including a transition between active and dormant phases. We found that swimming/feeding behavior gradually decreased from June, and completely disappeared by late August, indicating all individuals had entered estivation. Next, we focused on leptin, known as a feeding suppression hormone in various organisms, and examined leptin-A gene (AjLepA) expression in the brain that may regulate the seasonal behavioral pattern. AjLepA expression decreased after 7 days of fasting, suggesting that leptin has a function to regulate feeding in this species. The monthly expression dynamics of AjLepA during the feeding (active) and non-feeding (estivation) periods showed that the levels gradually increased with the onset of estivation and reached its peak when all the experimental fish had estivated. The present study suggests that the suppression of feeding activity by leptin causes shift in the physiological modes of A. japonicus before estivation.

Mechanism-based therapy of non-cardiac syncope: a practical guide.

The term non-cardiac syncope includes all forms of syncope, in which primary intrinsic cardiac mechanism and non-syncopal transient loss of consciousness can be ruled out. Reflex syncope and orthostatic hypotension are the most frequent aetiologies of non-cardiac syncope. As no specific therapy is effective for all types of non-cardiac syncope, identifying the underlying haemodynamic mechanism is the essential prerequisite for an effective personalized therapy and prevention of syncope recurrences. Indeed, choice of appropriate therapy and its efficacy are largely determined by the syncope mechanism rather than its aetiology and clinical presentation. The two main haemodynamic phenomena leading to non-cardiac syncope include either profound hypotension or extrinsic asystole/pronounced bradycardia, corresponding to two different haemodynamic syncope phenotypes, the hypotensive and bradycardic phenotypes. The choice of therapy-aimed at counteracting hypotension or bradycardia-depends on the given phenotype. Discontinuation of blood pressure-lowering drugs, elastic garments, and blood pressure-elevating agents such as fludrocortisone and midodrine are the most effective therapies in patients with hypotensive phenotype. Cardiac pacing, cardioneuroablation, and drugs preventing bradycardia such as theophylline are the most effective therapies in patients with bradycardic phenotype of extrinsic cause.

A Rare Case: Stenosis Doudeni Congenital et Causa Ladd Band Eet Causa Malrotation with Situs Inversus in 12 Days Old Baby

We are sharing a rare presentation of congenital duodenal obstruction with combined intrinsic and extrinsic causes with situs inversus, namely, duodenal stenosis with gastrointestinal malrotation in a neonate. The patient underwent successful exploratory laparotomy, Ladd's procedure, and appendicectomy were carried out. Early recognition of signs and symptoms, prompt corrective surgery, and adequate optimization of metabolic components post-operatively are important to determine the decreased morbidity and mortality of neonates.

Tracheobronchial abnormalities on computed tomography angiography in children with congenital heart disease.

To evaluate the assortment of tracheobronchial abnormalities on computed tomography angiography (CTA) in children with congenital heart disease (CHD). In this study approved by the Institute ethics committee, CTA studies of 182 children (age range: 2 days-8 years) with CHD, performed from July 2021 to March 2023 were analyzed. Two pediatric radiologists independently assessed the tracheobronchial airways (from the trachea to lobar bronchi) for developmental and branching anomalies and airway compromise (narrowing). In cases which demonstrated airway compromise, the extent and the cause of airway narrowing were evaluated, and the etiology were divided into extrinsic and intrinsic causes. Interobserver agreement between the two radiologists was calculated using kappa statistics. One hundred children demonstrated normal airway anatomy and no luminal narrowing. Airway narrowing was observed in 63 (34.6%) children (κ: 0.954), and developmental airway anomalies were seen in 32 (17.5%) children (κ: 0.935). Of the 63 children with airway narrowing, 47 (25.8%) children had extrinsic cause for narrowing, 11 (6%) children had intrinsic causes for narrowing, and 5 (2.7%) children had both intrinsic and extrinsic causes attributing to airway compromise. Significant airway narrowing (>50% reduction) was seen in 35 (19.2%) children (κ: 0.945). Tracheobronchial airway abnormalities are frequently associated in children with CHD and need to be appraised preoperatively. Cross-sectional imaging with CTA provides excellent information on tracheobronchial airway anatomy and caliber as well as delineates the possible etiology of airway narrowing, thus accurately diagnosing airway anomalies.

Clinical Presentation, Pathological Spectrum, and Outcomes of Alcoholic Cirrhosis-Related Immunoglobulin A Nephropathy

BackgroundIgA nephropathy associated with cirrhosis is frequent but often overlooked as largely considered silent. Until now, little has been known about their presentation and outcomes. MethodsWe conducted a retrospective multicenter study on patients with kidney biopsy-proven cirrhosis-related IgA nephropathy (cirrhosis-IgAN), diagnosed between 2009 and 2022. We mixed them up with 83 primary IgA nephropathy (pIgAN) diagnosed during the same period, using a partitioning clustering approach, to determine common clinicopathological profiles. ResultsAll the 46 patients with cirrhosis-related IgA nephropathy had an excessive alcoholic consumption. Clinical presentation was severe with acute kidney injury (AKI) in 79%, alternative causes of AKI was found in 62% of cases. Three clinicopathological clusters were identified: one represented chronic involvement, the second could be assimilated to mild disease, and the third corresponded to a MPGN pattern and was associated with heavy proteinuria and intrinsic AKI (without alternative causes). While the two first were equally distributed between pIgAN and cirrhosis-IgAN, the third was more frequent in patients with cirrhosis. The cumulative mortality rate in cirrhosis-IgAN was 26% and 46% at 1-year and 3-years. Steroid exposure and moderate/severe AKI were associated with higher mortality and steroid exposure was associated with the occurrence of severe infection. ConclusionOur results suggest that high AKI incidence is related to extrinsic causes in most cases but can also be driven by IgA-dominant MPGN in a subset of patients. Steroid use was associated with infectious disease and mortality. Further studies are needed to clarify the place of immunosuppressive treatment in cirrhosis-IgAN patients.

The Relationship between Academic Performance, Peer Pressure, and Educational Stress as It Relates to High School Students’ Openness to Seeking Professional Psychological Help

Adolescents, especially high school students, are more susceptible to stress and encounter other mental health issues. This is linked to extrinsic causes like academics, family, and friends. However, previous studies have shown low rates of students seeking professional psychological help for their problems. This study investigate the relationship among factors including academic performance, educational stress, peer pressure and openness to seeking professional psychological help. We conducted this study with 471 high school students (grades 10–12) engaged. The questionnaire was based on three measurements: peer pressure short form (PPSF), educational stress scale for adolescents (ESSA), and openness to seeking professional psychological help (ATSPPH_O). The Mann-Whitney U test, Kruskal-Wallis test and The PLS-SEM method were used to evaluate this research. The results showed that: (i) students with a higher level of peer pressure have a greater openness to seeking professional psychological help; (ii) the more open to seeking professional psychological help, the higher educational stress that students got; (iii) students with a higher level of peer pressure have greater educational stress; (iv) the openness to seeking professional psychological help would mediate the relationship between peer pressure and educational stress; (v) there was a significant difference between academic performance of peer pressure. On the one hand, counselors, clinicians, and therapists must identify students who are experiencing educational stress in the context of peer pressure as vulnerable groups in need of early mental health interventions. On the other hand, educators and teachers must consider the impact of peer pressure on students' academic performance and devise appropriate teaching strategies.

Feedback loops drive ecological succession: towards a unified conceptual framework.

The core principle shared by most theories and models of succession is that, following a major disturbance, plant-environment feedback dynamics drive a directional change in the plant community. The most commonly studied feedback loops are those in which the regrowth of the plant community causes changes to the abiotic (e.g. soil nutrients) or biotic (e.g. dispersers) environment, which differentially affect species availability or performance. This, in turn, leads to shifts in the species composition of the plant community. However, there are many other PE feedback loops that potentially drive succession, each of which can be considered a model of succession. While plant-environment feedback loops in principle generate predictable successional trajectories, succession is generally observed to be highly variable. Factors contributing to this variability are the stochastic processes involved in feedback dynamics, such as individual mortality and seed dispersal, and extrinsic causes of succession, which are not affected by changes in the plant community but do affect species performance or availability. Both can lead to variation in the identity of dominant species within communities. This, in turn, leads to further contingencies if these species differ in their effect on their environment (priority effects). Predictability and variability are thus intrinsically linked features of ecological succession. We present a new conceptual framework of ecological succession that integrates the propositions discussed above. This framework defines seven general causes: landscape context, disturbance and land-use, biotic factors, abiotic factors, species availability, species performance, and the plant community. When involved in a feedback loop, these general causes drive succession and when not, they are extrinsic causes that create variability in successional trajectories and dynamics. The proposed framework provides a guide for linking these general causes into causal pathways that represent specific models of succession. Our framework represents a systematic approach to identifying the main feedback processes and causes of variation at different successional stages. It can be used for systematic comparisons among study sites and along environmental gradients, to conceptualise studies, and to guide the formulation of research questions and design of field studies. Mapping an extensive field study onto our conceptual framework revealed that the pathways representing the study's empirical outcomes and conceptual model had important differences, underlining the need to move beyond the conceptual models that currently dominate in specific fields and to find ways to examine the importance of and interactions among alternative causal pathways of succession. To further this aim, we argue for integrating long-term studies across environmental and anthropogenic gradients, combined with controlled experiments and dynamic modelling.

Rapamycin protects mouse skin from ultraviolet B-induced photodamage by modulating Hspb2-mediated autophagy and apoptosis.

Continuous exposure to UVB is the main extrinsic cause of skin photodamage, which is associated with oxidative stress, DNA damage, apoptosis and degradation of collagen. Rapamycin, a mechanistic target inhibitor of rapamycin complex 1 (mTORC1), has been shown to play a crucial role anti-tumor and aging retardation, but its mechanism of action in UVB-induced photodamage still remains unknown. In this study, we investigated the role of rapamycin and Hspb2 (also known as Hsp27) in UVB-induced photodamage in mice. We constructed skin acute photodamage models on the ears of WT and Hspb2 KO mice, respectively, and administered rapamycin treatment. Histological results showed that knockout of the hspb2 exacerbated the skin damage, as evidenced by thickening of the epidermis, breakage and disruption of collagen fibers and reduction in their number, which is reversed by rapamycin treatment. In addition, hspb2 knockout promoted UVB-induced apoptosis and reduced autophagy levels, with a significant increase in p53 levels and Bax/Bcl-2 ratio, a reduction in LC3II/I ratio and an increase in p62 levels in the KO mice compared to those in WT mice after the same dose of UVB irradiation. Rapamycin was also found to inhibit collagen degradation induced by hspb2 knockdown through activation of the TGF-β/Smad signaling pathway. Rapamycin can alleviate skin photodamage from Hspb2 knockout to some extent. It may be a potential therapeutic drug for skin photodamage. In this study, we investigated the role of rapamycin and Hspb2 in UVB-induced photodamage in mice. Histological results showed that knockout of the hspb2 exacerbated the skin damage, as evidenced by thickening of the epidermis, breakage and disruption of collagen fibers and reduction in their number, which is reversed by rapamycin treatment. In addition, hspb2 knockout promoted UVB-induced apoptosis and reduced autophagy levels. Rapamycin was also found to inhibit collagen degradation induced by hspb2 knockdown through activation of the TGF-β/Smad signaling pathway. We conclude that rapamycin and Hspb2 exert a synergistic protective effect in skin photodamage.

Complete Heart Block Secondary to Section Concomitant Use of Metoprolol and Fluoxetine in a Case of Chronic Depression and Systemic Hypertension: A Case Report

Bradyarrhythmia can be brought on by intrinsic or extrinsic causes that disrupt the cardiac conduction system, with iatrogenic drug usage being the most common extrinsic cause. Atrioventricular (AV) block is frequently brought on by beta-blockers, calcium channel blockers, anti-arrhythmics, and digoxin. The first course of treatment for heart block involves stopping the problematic medications. Psychotropic medications have the potential to cause cardiotoxic adverse effects that affect the heart. In a patient with a pre-existing cardiac disorder, psychotropic drugs can manifest with dangerous arrhythmias. It is yet unknown what intricate processes cause these effects. A variety of arrhythmias may be brought on by or made worse by many commonly used drugs. Hereby, the authors present a case report of 56-year-old hypertensive male, a known case of chronic depression with chest heaviness. The Electrocardiogram (ECG) revealed Complete Heart Block (CHB) with Right Bundle Branch Block (RBBB). The patient was on fluoxetine and beta-blockers for his mental illness and hypertension. Three days after withholding the drugs, the CHB resolved, and his baseline ECG remained as RBBB. The present case highlights the interaction of drugs leading to CHB in present patient. Therefore, the importance of a detailed drug history in such cases becomes imperative.

Bladder outlet obstruction in women: Scope of the problem and differential diagnosis

AbstractIntroductionThe prevalence, formal definition, and diagnostic criteria of bladder outlet obstruction in owmen have not been clearly defined.MethodsThis is a literature review of the definition of BOO in women, its prevalence, as well as its differential diagnosis.ResultsThe main causes of BOO in women are divided into functional and anatomic conditions. Functional etiologies include detrusor external sphincter dyssynergia, dysfunctional voiding, Fowler's syndrome, and primary bladder neck obstruction. Anatomic causes can be further divided into extrinsinc and intrinsic conditions. Intrinsic etiologies include urethral stricture and urethral diverticula, whereas extrinsic causes comprise pelvic organ prolapse, post anti‐incontinence surgery, and Skene's gland cyst or abscess.ConclusionsThere are multiple etiologies to BOO in women, and this condition is most probably underdiagnosed, owing to a lack of consensus for a standard definition.

Autonomous Agency in Anti‐Dualistic Social Ontologies: A Compatibilist Notion

AbstractAnti‐dualistic social ontologies, those highlighting the intrinsic interdependency of agency and structure as two sides of the same coin, are sometimes criticized for failing to provide a satisfactory account of autonomous – capable and free – agency, or even denying the reality of such agency. This paper contests these claims, arguing that anti‐dualistic ontologies only conflict with autonomous agency when the latter is understood in a highly voluntaristic sense, whose ideational roots go to what philosophers of free will call “incompatibilist” intuitions of freedom. Those intuitions suggest that actions (intentions, decisions) ultimately determined by extrinsic causes lack the kind of freedom presupposed by moral responsibility, so when agentive autonomy is presumed to involve such freedom, it does indeed cohere poorly with the anti‐dualistic picture of intrinsically structured agency. Herein, however, an alternative, “compatibilist” notion of autonomy is advanced, such that does not conflict with extrinsic determination and is therefore congruent with anti‐dualistic social ontologies.

Nontraumatic Spine Emergencies: A Primer for the On-Call Radiologist

Myelopathy is defined as rapidly developing muscle weakness, sensory deficit, and loss of bowel and bladder sphincter control. The differential for atraumatic myelopathy includes both extrinsic and intrinsic causes, with the former including disc herniations with compressive myelopathy, osteomyelitis with epidural abscess, and leptomeningeal spread of disease whereas the latter includes acute inflammatory processes like Guillain-Barre syndrome or demyelinating disease, and spinal cord tumors.

Indoor falls and number of previous falls are independent risk factors for long-term mortality after a hip fracture

BackgroundHip fractures are almost always the result of a fall. Causes and circumstances of falls may differ between frail and vigorous patients.AimTo describe the circumstances of falls causing hip fractures, number of falls during the previous year, and their association with long-term mortality.Patients and methodsThe study is a retrospective review conducted in a tertiary university hospital serving a population of 425,000 inhabitants in Barcelona. All patients admitted with hip fractures with medical records describing the circumstances and number of previous falls were included. The number of falls in the previous 12 months was recorded, including the one causing the fracture. The circumstances of the index fall were dichotomized according to whether it was from the patient’s own height or above; day or night; indoors or outdoors, due to intrinsic or extrinsic causes. Cumulative mortality was recorded for almost 5 years after hip fracture.ResultsIndoor falls were strongly associated with shorter survival. Falling more than once in the previous year was also a risk factor for long-term mortality (hazard ratio 1.461, p < 0.001 and hazard ratio 1.035, p = 0.008 respectively).ConclusionIndoor falls and falling more than once in the previous year are long-term risk factors for mortality after hip fractures. It is always essential to take a careful patient history on admission to determine the number of falls and their circumstances, and special care should be taken to reduce mortality in patients at high risk.

A Simple Model of the Rise and Fall of Civilizations.

The literature on the fall of civilizations spans from the archaeology of early state societies to the history of the 20th century. Explanations for the fall of civilizations abound, from general extrinsic causes (drought, warfare) to general intrinsic causes (intergroup competition, socioeconomic inequality, collapse of trade networks) and combinations of these, to case-specific explanations for the specific demise of early state societies. Here, we focus on ancient civilizations, which archaeologists typically define by a set of characteristics including hierarchical organization, standardization of specialized knowledge, occupation and technologies, and hierarchical exchange networks and settlements. We take a general approach, with a model suggesting that state societies arise and dissolve through the same processes of innovation. Drawing on the field of cumulative cultural evolution, we demonstrate a model that replicates the essence of a civilization's rise and fall, in which agents at various scales-individuals, households, specialist communities, polities-copy each other in an unbiased manner but with varying degrees of institutional memory, invention rate, and propensity to copy locally versus globally. The results, which produce an increasingly extreme hierarchy of success among agents, suggest that civilizations become increasingly vulnerable to even small increases in propensity to copy locally.

Degradation Mapping and Impact of Device Dimension on IGZO TFTs BTI

We studied the impact of gate and drain stress biases combination on IGZO based TFTs degradation targeting hot carrier regime. We show that typical signatures of this mechanism (e.g., saturation current degradation and SS increase) are not visible even at high drain biases, while a gate bias dependence only (BTI) is present in most of the degradation data. We also identify an unexpected gate-length dependence of BTI, for which different extrinsic causes are investigated.

Evaluation of early functional outcome of arthroscopic decompression in chronic primary sub-acromial impingement syndrome

&lt;b&gt;Background:&lt;/b&gt; Sub-Acromial Impingement Syndrome (SAIS) spectrum ranges from acute inflammation to chronic degeneration of the bursa and of rotator cuff tendons in sub-acromial space. It may lead to a full-thickness tear of rotator cuff tendons and degenerative joint disease of the shoulder girdle leading to functional loss and disability if not treated early and adequately. This study aimed to determine the early functional outcome of arthroscopic sub-acromial decompression in chronic SAIS due to mechanical causes.&lt;br /&gt; &lt;b&gt;Material and methods:&lt;/b&gt; This was a prospective cohort study. Patients were operated on arthroscopically for sub-acromial decompression between September 2018 and March 2020. Thirty-five patients with a range of 20 to 65 years of age diagnosed clinically with primary chronic sub-acromial impingement syndrome meeting the inclusion criteria were included in this study. All the patients under study were initially kept for at least four weeks of a course of conservative treatment and persisted in having symptoms were treated surgically with arthroscopic sub-acromial decompression. The UCLA (The University of California at Los Angeles) shoulder rating scale was used to assess shoulder function. The assessment was done in the pre-operative period, four weeks, 12 weeks, and 16 weeks post arthroscopic sub-acromial decompression surgery.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; Compared to pre-operative UCLA shoulder function score at the end of non-operative conservative treatment, the patients under study showed a statistically significant improvement at the end of the 16th week of post-arthroscopic subacromial decompression (p&amp;lt;0.0001).&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; This study concludes that arthroscopic sub-acromial decompression provides a good functional outcome in patients having primary shoulder impingement due to extrinsic mechanical causes such as shape and slope of the acromion in the absence of significant (total or near total) rotator cuff tear after 16 weeks of follow-up.