ABSTRACT
Cerebral vascular malformations constitute one of the key abnormalities in children with PHACE syndrome, which is characterized by Plaque like cutaneous hemangiomas, Posterior fossa abnormalities, arterial Cerebrovascular and Eye abnormalities, with or without Sternal clefts (PHACES when sternal clefts are present), and associated midline anomalies. Both moyamoya arteriopathy and intracranial aneurysms have been reported in children with this syndrome. Herein, we report the successful treatment of a growing left posterior-communicating artery aneurysm arising from an aberrant left internal carotid artery (LICA) with balloon assisted coiling (BAC) in a child with PHACE syndrome. We circumvented the limitations posed by the narrow caliber of the proximal LICA, by successfully navigating a coiling microcatheter from the basilar artery into the LICA via a persistent trigeminal artery. BAC was then achieved using a Scepter Mini balloon microcatheter for aneurysm neck remodelling.
ABSTRACT
Cerebral vascular malformations constitute one of the key abnormalities in children with PHACE syndrome, which is characterized by Plaque like cutaneous hemangiomas, Posterior fossa abnormalities, arterial Cerebrovascular and Eye abnormalities, with or without Sternal clefts (PHACES when sternal clefts are present), and associated midline anomalies. Both moyamoya arteriopathy and intracranial aneurysms have been reported in children with this syndrome. Herein, we report the successful treatment of a growing left posterior-communicating artery aneurysm arising from an aberrant left internal carotid artery (LICA) with balloon assisted coiling (BAC) in a child with PHACE syndrome. We circumvented the limitations posed by the narrow caliber of the proximal LICA, by successfully navigating a coiling microcatheter from the basilar artery into the LICA via a persistent trigeminal artery. BAC was then achieved using a Scepter Mini balloon microcatheter for aneurysm neck remodelling.
ABSTRACT
Background: Treating injuries with heat can increase blood flow and make connective tissue more flexible. It can also help minimize inflammation and reduce the incidence of edema or fluid retention. By increasing blood flow to the site of an injury, the deep heat generated with diathermy can accelerate healing. Diathermy is used to treat arthritis, back pain, fibromyalgia, muscle spasms, neuralgia, sprains and strains, tenosynovitis, tendonitis, bursitis. In the second, as an adjunct to surgery, diathermy is used to coagulate, prevent excessive bleeding, and seal off traumatized tissues. It is particularly effective in eye surgery, neurosurgery and dermatology. However, there is still not a lot of evidence to prove that diathermy is the most effective treatment for these conditions. Aim of the study: Aim was comparison of Diathermy incision and Scalpel incision in elective open appendectomy surgery. Materials and methods: 25 patients per group irrespective of sex was sample size. Study Group was subdivided into Study Group A – Patients were subjected to Diathermy incision. Study Group B – Patients were subjected to Scalpel incision. After obtaining pre-anesthetic check-up patients were posted for surgery. Data was collected using a proforma meeting the objectives of the study. Results: The treatment group was split into two, Twenty-five cases used diathermy for skin incision and the other twenty-five cases used a traditional scalpel for skin incisions in open appendectomy Mithun Govind Dandapani, Bharathidasan Rajamanikkam, Maheshwari Narayanan. A randomized comparative study of diathermy incisions and scalpel incisions in subacute appendicitis. IAIM, 2019; 6(7): 59-66. Page 60 procedures. 50 patients in the study groups were compared, 4 developed wound gaping which accounts for 8%. Wound gaping was considerably seen in scalpel incision with a highly significant P value of 0.0297 using Pearson-Chi square test. A hypertrophic scar was seen in scalpel incision with a significant P value of 0.074 using Pearson-Chi square test. Keloid was considerably seen in scalpel incision with a highly significant P value of 0.0149 using Pearson-Chi square test. The pain in POD-1 was compared, the mean value was 7.44 and 6.16 in scalpel and diathermy respectively, with a highly significant P value of <0.0001. The pain in POD-2 was compared, the mean value was 6.28 and 4.72 in scalpel and diathermy respectively, with a highly significant P value of <0.0001. Conclusion: All the patients were followed every day in the postoperative period until they were discharged. The following parameters were observed, that is a comparison of the two procedures with relation to the duration of incision, postoperative pain, post-operative complications in both the procedures. Diathermy is the first choice of incision for open appendectomy procedures as there is less chance of postoperative wound complications.
ABSTRACT
Background: The link between varicocele and infertility was first reported by cessius in 1st century AD but it was not widely acknowledged until TULLOCH and colleagues reported the improvement of sperm parameters in 26 of 30 patients undergoing varicocelectomy. Varicocele is defined as excessive dilatation of pampiniform venous plexus of spermatic cord. varicocele is an important cause infertility which can be corrected by surgery. Several methods have been used for its treatment including open surgical ligation of spermatic veins as well as laparoscopic varicocelectomy. Open varicocelectomy has more risk of recurrence and complications whereas laparoscopic varicocelectomy is simple, has less risk of recurrence and complication in expert hands. Objectives: To compare Laparoscopic varicocelectomy with open varicocelectomy, in terms of postoperative pain, recurrence rate, hospital stay, cost, cosmetic and complication. To prove hospital stay was more in open group than laparoscopic group and also patient of laparoscopic group return to normal activities earlier than open group. To standardize the laparoscopic varicocelectomy procedure for varicocele. Materials and methods: It was a randomized clinical trial done in Department of General Surgery, Vinayaka Mission Medical College, Karaikal. Study was carried out from 1 st March, 2015 to 1st R. Bharathidasan, Reny Jayaprakash, Subith P. Bhaskar, G. Ambujam. Laparoscopic varicocelectomy now the gold standard procedure for varicocele - A comparative study with open technique based on our experience. IAIM, 2017; 4(7): 218-221. Page 219 March, 2016. A total 70 patients was taken in our study of its 36 patient undergone open varicocelectomy and 34 patient undergone laparoscopic varicocelectomy. Results: Recurrence rate 0% in Laparoscopic Varicocelectomy and 5.6% in open varicocelectomy. Wound complication was 0% in Laparoscopic varicocelectomy and 2.5% in open varicocelectomy. Post-operative pain was more in open group as compared to laparoscopic varicocelectomy. Laparoscopic varicocelectomy has less post-operative morbidity and early return to normal activity. Also there was improvement in seminal analysis in both groups. Conclusion: We would like to standardize laparoscopic varicocoelectomy and make it as a gold standard for Varicocele by replacing open technique provided there is good experienced surgical team and good instrumentation. Cost of the procedure is comparatively high.
ABSTRACT
Background: This study focus on the varying presentation, hormonal influence, and biochemical marker for a series of patient with undescended testis and their influence over descend and imaging modality and various diagnostic approaches towards the undescended testis. Materials and methods: Patients who had attended vinayaka mission medical college, karaikal with the complaints of absence of testis and infertility included in this study and it is a prospective clinical study which was carried from 2014 – 2016 June. All treatment modality were carried out according to the diagnosis confirmed by both clinically and imaging after obtaining concern from the patients. Results: all hormonal and bio chemical marker were taken for all the patients and they were evaluated. In that testosterone showed little on lower side with patients with infertility, insulin like 3 peptide was on lower side for more than fifty percent of patient mainly who were in adolescent age. In patients whose presentation of testis can’t be assessed by either clinical and ultrasonography diagnostic laparoscopy was done and testis were found out. Conclusion: Testosterone has significant effect in descend of the testis and mainly in the patients with infertility. Insulin like peptide 3 can be used as a prognostic marker to assess the viability of the testis and diagnostic laparoscopy remains gold standard invasive diagnostic tool where the testis is not seen clinically and imaging.
ABSTRACT
Beta-hemolytic Enterococcus faecalis was isolated from the pericardial fluid obtained from a patient with pyopericardium. The patient was immunocompetent and had mild pleural effusion. He was treated with parenteral co-amoxiclav and amikacin, had underwent pericardiectomy with repeated pericardial aspiration, and recovered completely. To our knowledge, this is the first report of pyopericardium due to E. faecalis .