European Journal of Molecular & Clinical Medicine

Background:The aim of our study is to, Analyze the incidence, pathophysiology, clinical
features and various treatment options for cervical compressive myelopathy.Predicting
the surgical outcome in anterior cervical approach in cervical compressive myelopathy.
Materials and Methods: The present study is a prospective study comprising of 90 cases
of cervical spondylotic myelopathy. Studied over a period from September 2013 to
December 2015 in the department of neurosurgery, RMC, GGH, Kakinada. The cases
included in this study were cases of cervical spondylotic myelopathy with ventral
compression or 2 or 3 level of PIVD.
Results: The youngest patient in our study was 18 years old, whereas the eldest patient
was 70 years old. The mean age in our study was 45.7 years. The commonest clinical
presentation in our study was motor symptoms. Out of 46 grade I and II (mild) cases,
86.95% (40 cases) (10 cases) had improvement and 13.04% were remained as such
after1 month Of surgery. In moderate cases (grade III and IV) 70% cases improved,
27.5% cases remained static & 2.5%(1 case) developed Ml in post op period. In 4 severe
cases, 2 cases remained as such whereas 2 cases expired on 2ndpost operative day
because of myocardial infarction. Patients who are operated for single level lesion
showed 100% improvement after 6months followed by 2 level lesion it showed an
improvement of 74% after 6 months and 3 level lesions With 56% after 6months.
Conclusion: In cervical spondylotic myelopathy with anterior compression,
decompression by posterior surgery is ineffective as you can’t remove osteophytes more
over multilevel cervical spondylotic myelopathy is accompanied by various levels of
nerve root compression and posterior surgery is ineffective for the decompression of
nerve roots resulting in persistence of post operative symptoms.

COVID-19, the global pandemic affecting economic developments has been regarded as severe pulmonary dysfunction disease. The disease has caused significant mortalities all around the world. The reports suggest that major reason for patients’ death are multiple organ failure, sudden cardiac arrest, severe respiratory dysfunction and body shock. These clinical conditions are majorly linked with COVID-19 comorbidities which are severely affecting disease severity. The present study describes pathophysiological findings associated with multiorgan effect of COVID-19. The study describes possible transmission route of the virus, responsible for gastro intestinal problems. The review of pathophysiological findings in COVID-19 provides a perspective to focus our therapeutic research strategies towards controlling the effect of pathogenic virus on indirectly targeted body organs. The present study will help in controlling disease morbidities as well as preventing long term effects of COVID-19.

This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. The abnormal dilatation and distortion of the vascular channel, together with destructive changes in the supporting connective tissue within the anal cushion, is a paramount finding of hemorrhoids. It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development, and could be a potential target for medical treatment. In most instances, hemorrhoids are treated conservatively, using many methods such as lifestyle modification, fiber supplement, suppository-delivered anti-inflammatory drugs, and administration of venotonic drugs. Non-operative approaches include sclerotherapy and, preferably, rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is invariable. Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence. The applications and outcomes of each treatment are thoroughly discussed.

ARDS (acute respiratory distress syndrome) and COVID 19 is an alarming concern in the recent n-CoV pandemic. The main pathophysiological events include the severity of hypoxemia and poor respiratory mechanics. The acute respiratory distress syndrome (ARDS) accounts for 40% mortality in about 200,000 critically ill patients annually within the United States including the recent covid pandemic. ARDS is as a result of protein-rich pulmonary edema that causes excessive hypoxemia and impaired carbon dioxide release. The medical disorders related to the development of ARDS consist of sepsis, pneumonia, aspiration of gastric contents, and predominant trauma. The lung injury is caused by pro-inflammatory cytokine release and platelet based damage to the endothelial and epithelial boundaries of the lung. Resolution is delayed due to damage to the lung epithelial barrier, which prevents removal of alveolar edema fluid and deprives the lung of adequate quantities of surfactant. However, there is no effective pharmacological remedy, despite the fact that cell-based total remedy and different therapies currently being tested in scientific trials may additionally provide novel treatments for ARDS. This review thus highlights on the various factors underlying the covid - 19 mediated ARDS.