Anandaiah.pptx
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A 68-year-old male patient presented with low back ache radiating to both lower limbs up to the ankles, worse on the left side, for 1 year. He experiences neurogenic claudication after 500 meters of walking. He has a history of type 2 diabetes mellitus and an MRI diagnosis of L4-L5 canal stenosis. On examination, he has normal muscle tone and bulk with slightly reduced lower limb strength of 4+/5 in the hips, knees, ankles, and EHL bilaterally. Reflexes are reduced in the knees and ankles. Sensory examination and cerebellar signs are normal.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Anandaiah.pptx
- 1. Name- Anandaiah Age- 68/M Mrd no- 1200601 Diagnosis – L4-L5 canal stenosis Comorbidities- DM type 2
- 2. A 68/M patient who is right handed by nature , -c/o low back ache radiating to both lower limbs upto ankle, (left>right) for 1 year. - Neurogenic claudication of 500 mtrs present - No paresthesia - No h/o trauma - No bowel, bladder symptoms - No slippage of chappals
- 3. MOTOR SYSTEM: Tone • Normal in both upper and lower limbs Bulk • Normal in both upper and lower limbs
- 4. Power - right left Upper limb Shoulder- 5/5 5/5 Elbow- 5/5 5/5 Wrist- 5/5 5/5 Lower limb Hip- 4+/5 4+/5 Knee- 4+/5 4+/5 Ankle- 4+/5 4+/5 EHL- 4+/5 4+/5 • Reflexes – • Superficial reflexes-present • DTR: BJ TJ S KJ AJ Right - 2+ 2+ 2+ 1+ 1+ Left - 2+ 2+ 2+ 1+ 1+ Plantars- both flexors
- 5. Sensory system-normal Cerebellar signs: no Tandem Gait : normal Meningeal signs: no