Comparison of Open and Endoscopic Approach in Carpal Tunnel Release: A Systematic Review

I Kadek Adi Surya Pramana, Ni Nyoman Nila Manta Ary Putri — Fri, 18 Jul 2025 00:00:00 +0000

Carpal Tunnel Syndrome (CTS) is a musculoskeletal disorder caused by the compression of the median nerve, with an incidence of 1 to 3 cases per 1000 people annually and a prevalence of 50 per 1000 in the United States. The two main surgical treatments for CTS are open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR). This study aims to compare the outcomes of ECTR and OCTR based on randomized controlled trials (RCTs). A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on RCTs published between 2013 and 2023. The outcomes analyzed included the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-S), Boston Carpal Tunnel Questionnaire Functional Status Scale (BCTQ-F), VAS score, and postoperative complications. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were used to assess the level of evidence. Seven studies, including 271 hands treated with ECTR and 285 hands treated with OCTR, were reviewed. The comparison results showed minimal differences in BCTQ-S (MD=0.06), BCTQ-F (MD=0.02), VAS (MD=0.03), and complications (ECTR vs OCTR = 5 vs 9). Both ECTR and OCTR produced similar results, with only slight differences observed. In conclusion, ECTR and OCTR offer comparable outcomes based on BCTQ-S, BCTQ-F, VAS score, and postoperative complications. Despite some differences, these findings should be interpreted cautiously and not considered conclusive.

Correlation Between Lactate Dehydrogenase (LDH) Values and Aspects Score at the Beginning of Treatment in Acute Ischemic Stroke

Lathifatul Fikriyah — Thu, 17 Jul 2025 00:00:00 +0000

Stroke is the second leading cause of death worldwide, with ischemic stroke comprising 87% of cases. Metabolic acidosis from hypoxia promotes anaerobic glycolysis, raising lactate dehydrogenase (LDH) levels, which reflects neuronal tissue injury and inflammation in acute ischemic stroke. The Alberta Stroke Program Early CT Score (ASPECTS) is used to assess ischemic brain injury on non-contrast CT, aiding early prognosis and treatment decisions. This cross-sectional study at Dr. Soetomo Hospital, Surabaya (February–May 2023), included 30 acute ischemic stroke patients (53.3% male, mean age 60.2 ± 7.1 years, onset 2–5 days). Exclusion criteria were prior thrombolysis, cancer, or organ failure. LDH levels were measured at admission using the Alinity C analyzer, and ASPECTS was calculated from initial CT scans. Spearman’s correlation was used for analysis. Results showed a significant inverse correlation between LDH and ASPECTS (r = -0.279, p = 0.003), indicating that higher LDH levels correspond with lower ASPECTS (larger infarcts). Mean LDH was elevated (258.75 ± 50.65 U/L, normal 120–190 U/L). Comorbidities included hypertension (90%), dyslipidemia (83.3%), and diabetes mellitus (56.7%). These findings suggest that serum LDH may be a valuable adjunct biomarker for early assessment of ischemic stroke severity when advanced imaging is unavailable, helping clinicians estimate infarct size rapidly. Further research involving larger populations is recommended to confirm LDH’s utility and to examine its combination with other biomarkers for acute ischemic stroke management.

Jurnal Health Sains

Comparison of Open and Endoscopic Approach in Carpal Tunnel Release: A Systematic Review

Correlation Between Lactate Dehydrogenase (LDH) Values and Aspects Score at the Beginning of Treatment in Acute Ischemic Stroke