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Nat Clin Pract Neurol ; 2 Ma H, Kim I. The diagnostic assessment of hand elevation test in carpal tunnel syndrome. J Korean Neurosurg Soc ; 52 Practice parameter: electrodiagnostic studies in carpal tunnel syndrome. Neurology ; 58 Melzack R. The McGill Pain Questionnaire: major properties and scoring methods.

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Pain ; 1 A self administered questionnaire for assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am ; 75 Ahn DS. Hand elevation: a new test for carpal tunnel syndrome. Ann Plast Surg. Classification of carpal tunnel syndrome by nerve conduction and electromyographic criteria. J Hand Surg Eur ; 33 Median nerve motor conduction velocity and latancy, median nerve distal sensory latancy. In: Delisa JA, editor.

Manual of nerve conduction velocity and clinical neurophysiology.

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New York: Raven Press; A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment. Evaluation of thermography in the diagnosis of carpal tunnel syndrome: comparative study between patient and control groups. J Korean Neurosurg Soc ; 39 Dawson DM.

Entrapment neuropathies of the upper extremities. N Engl J Med ; Report J, Spinner M. Outcomes for peripheral nerve entrapment syndromes. Clin Neurosurg ; 53 Bland JD. Treatment of carpal tunnel syndrome. Muscle Nerve ; 36 Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome. BMC Musculoskelet Disord ; 4 Value of the carpal compression test in the diagnosis of carpal tunnel syndrome.

J Hand Surg Br ; 22 Median nerve conduction impairment in patients with diabetes and its impact on patients' perception of health condition: a quantitative study.

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Diabetol Metab Syndr ; 25 Hand elevation test for assessment of carpal tunnel syndrome. J Hand Surg Br. Carpal tunnel syndrome: diagnostic application of MRI and sonography. Operative time min Ischemic time min As regard sex distribution between the 5 groups; in our study, females were more common because most our patients had rheumatic heart disease RHD that affects females more than males.

Our results were similar to Carapetis et al.

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In our study, in obese patients these was highly significant difference among 5 groups as regard diabetes mellitus. Our results were similar to Wigfield et al who documented that obese patients were more likely to be diabetic and hypertensive which was also similar what documented by Amy. In our study the patients had RHD that needed multiple valvular surgical interventions as was shown in Table 2.

DVR only had significant difference between the 5 groups. Our results were not similar to Parwis et al who documented that obesity was a self-determining interpreter of hospital death in patients who performed valve surgery [14]. Our results were similar to William et al who documented that patients having AVR showed equal survival in patients with low and high BMI [15]. Vinod et al who stated that patients with BMI 24 or less were at considerably augmented jeopardy of inhospital and long-term death after cardiac valvular surgery.

This high-risk people needs cautious risk stratification and choices for less-invasive valve treatments [16]. In our study the mean ICU stay days in the 5 groups were 3. Our results were similar to Yazdanian et al who stated that comparable hospitalization and ICU stay were found between obese and normal-weight [17]. On the other hand, our results were not similar to Parsonnet et al who stated that obese patients had elongated hospital stay and Rockxet al also documented that raised BMI was accompanied with prolonged ICU days [18,19].

In our study, mechanical ventilation MVT time had no significant difference between the 5 groups. Our results were similar to Cheung W. Our results were not similar to Potapov et al who stated that in obese patients MVT was elongated than in the normal weight people. So, recruitment exercises more to PEEP are essential to increase oxygenation and compliance lacking negative impact on the respiratory task [23]. Arrhythmia occurrence in our study was shown in Table 3 with no significant differences between the 5 groups. Our results were in accordance with Yap et al and Dehbozorgi.

Our results disagreed with Zacharias et al who stated that augmented stages of obesity was accompanied with more threat for the progress of new onset atrial fibrillation following cardiac surgery. Kannel et al stated that the suggested theory for the link between atrial fibrillation and obesity was not the DM, but the left atrial expansion as a consequence of raised plasma volume, changed autonomic tone, and increased neurohormonal stimulation [27,26].

Regarding exploration percentage in our study, there were no significant differences among 5 groups. Our results similar to Rahmanian et al [9]. Yazdanian et al and Sun et al demonstrated that extremely obese patients had diminished needs for blood products transfusion probably due to their diminished haemdilution during CBP [17,28]. This may also decline cardiopulmonary bypass—generated coagulopathy that decreases the frequency of postoperative hemorrhage [29]. As regard renal impairment, no significant differences between the 5 groups were found. However this disagreed with other studies demonstrating more liability to renal dysfunction in obese patients [6,13,31,30].

In our study, no significant differences regarding pulmonary embolism and neurological complications were found among the 5 groups. The same finding was present in other studies [32,33]. Regarding Surgical Site Infection SSI percentage in the 5 groups of this study there was a significant difference between 5 groups [Table 4]. This hazard may be enriched by diabetes mellitus and physicians necessity give specific care to wound healing in patients with numerous risk aspects.

The same conclusion was reached by other studies [32,33,34]. Loopetal who documented that the predictable incidence of postoperative mediastinitis has been linked to obesity but may be mostly associated with diabetes mellitus and perioperative hyperglycemia with the presence of other comorbid conditions prevalent in this patient group [35].

Obesity and morbid obesity were both related to a high hazard of deep sternal wound infection [36,37,6,30]. Our results not similar Rahmanian et al who reported that Former reports have demonstrated a link between obesity and postoperative illness, such as wound infection, renal failure or happening of atrial fibrillation.

Wigfield et al. Our study showed postoperative mortality percentage in the 5 groups with no significant differences. Our results similar Yap et al stated that This discovery is analogous to new modern reports showing results in obese people and Cheung W. We recovered no obesity related to with raised postoperative illness or mortality rate except for only surgical site infection.

Our results were similar to Hysi etal stated that severely obese people can have no operative death or illness raise apart from wound infection [33].

Optimization Method for Forecasting Confirmed Cases of COVID-19 in China.

Engelman et al documented that several theories give explanation for the absence of raised illness risk in people with high BMI, who need heart surgery. People with a low BMI may be more hemodiluted by a fixed bypass circuit during cardiopulmonary bypass. This may lead to postoperative weight gain, transfusion demands, and duration of hospitalization [8]. Reeves et al stated that another theory may be that people with elevated BMI, and a high portion of body fat have more dietary store, which may give them some protection against complications [5].

Vaduganathan et al showed that obese patients without difference between obese subgroups had higher life chance post valve operations than normal-weight people, so supporting the concept of the 'obesity paradox' [38]. Focus should be placed on these populations in risk assessment, preparation, and resource allocation prior to cardiac surgery [40]. Our study did not assist the remarkably held idea that obese people were at raised hazard of operative death; so the term Obesity paradox should be changed.

Overall, heart valve surgery can be done with satisfactory early results in obese patients like non-obese. In conclusion, we found that obesity did not corelate with raised postoperative illness or mortality rate except for only surgical site infection. More studies are necessarily to be done to study the effect of obesity on the intermediate and long-term results of patients after heart valve surgery.

Addressing the dual burden of malnutrition in Egypt: do conditional cash transfers have a role report.

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Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery. J Am Coll Cardiol ;— Obesity and early complications after cardiac surgery. Med J Aust ; 7. Obesity in Saudi Arabia. Saudi Med J ;—9. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery.

J ThoracCardiovascSurg ;— Impact of body mass index on early outcome and late survival in patients undergoing coronary artery bypass grafting or valve surgery or both. Am J Cardiol ;—8. Does an obese body mass index affect hospital outcomes after coronary artery bypass graft surgery? Ann ThoracSurg ;— Is extreme obesity a risk factor for cardiac surgery?

Eur J Car-diothoracSurg ; 29 — Effect of body mass index on survival in patients having aortic valve replacement for aortic stenosis with or without concomitant coronary artery bypass grafting. Am J Cardiol ;— The impact of body mass index on morbidity and short- and long-term mortality in cardiac valvular surgery.

Impact of body mass index on in-hospital mortality and morbidity after coronary artery bypass grafting surgery.

J Tehran Univ Heart Cent ;3 1. A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. Circulation ;79 6 Pt 2 :I3— Can J Surg ;—8. Impact of body mass index on outcome in patients after coronary artery bypass grafting with and without valve surgery. Eur Heart J ;— Obesity is associated with increased morbidity but not mortality in critically ill patients. Intensive Care Med ; — PMID: Circ J ;— Increased body mass index and peri-operative risk in patients undergoing non-cardiac surgery. ObesSurg ; — Outcomes of the morbidly obese having cardiac surgery.

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The effects of body mass index category on early outcomes of coronary artery bypass graft. ARYA Atheroscler ;3 2.

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