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Objectives: To compare the efficacy between endoscopic and open carpal tunnel release procedures for carpal tunnel syndrome patients. Design and setting: Randomised control study in a single neurosurgery department Participants: 30 patients aged 35-69 years with clinically diagnosed carpal tunnel syndrome Main outcome measures: Primarily - operative duration, bleeding, pain score on day one, requirement of non-steroidal anti-inflammatory drugs (NSAIDs), time spent in hospital and days taken to return to work. Other outcomes include infection, wound status/cosmesis, injury to median nerve, chronic regional pain syndrome and patient satisfaction. Results: 15 patients were allocated to open surgery, and the other 15 for endoscopic. The average operative duration for open surgery was 9.9 minutes compared to 52 minutes spent for the endoscopic procedure. Cauterization had to be performed 4:1 times in endoscopic compared to open. Pain scores rated 3x higher after open surgery and resulted in increased NSAIDs use. Time spent in hospital after open surgery was 0.7 hours compared to 2.2 in endoscopic, however patients were able to return to work an average of 10.6 days earlier after endoscopic surgery. Conclusions: In carpal tunnel syndrome, endoscopic surgery allowed patients to experience less post-operative pain and return to work several days sooner than in open surgery.

Introduction: The recent COVID-19 pandemic has revealed important obstacles in our health care systems, including online specialist consultations. Amidst mass lockdowns and social distancing, we observed the importance of developing a consistent method of performing effective neurological examinations that yield accurate results in a time efficient manner. Objectives: To describe our experience in the Maldives of performing effective online neurological examination. Methodology: We designed and implemented a platform for patients to register for online consultation, collected a comprehensive neurological history, including pictures/scroll-videos of past radiological reports, and guided the patient and their aide through neurological examination methods- both verbally through online video consultation and informative pictorials that depict exactly how-to perform said examinations. Conclusions: Neurological examinations are time consuming, detailed and require skill and expertise to be performed appropriately. Yet, can be customized and adapted to be performed remotely. Proper guidance by examiner and assistance by family or friend with use of pictorials can conclude a thorough online examination.