ABSTRACT
Introduction: Traumatic diaphragmatic injuries arepotentially life-threatening due to herniation of abdominalorgans into the pleural cavities. They can be easily overlookedon initial diagnostics and a high index of suspicion is required.Aim: To analyse the various traumatic diaphragmatic hernias.Material and methods: A clinical study to analyse 50 patientsin our experience with patients suffering from traumaticdiaphragmatic rupture.Results: 18-50 yrs of age group is the most affected age groupwith diaphragmatic hernias, gender wise males with bluntinjuries are more in study. Right sided is the more affectedside. The cause of diaphragmatic rupture was blunt injuriesin 23 cases and penetrating injury in 5 cases. 3 patients withacute presentation had uneventful recovery, 2 patients had bileperitonitis and one died. In the cases with late presentation, allpatients had uneventful recovery but for 9 patients who hadintestinal obstruction. On the 6th.post-op day, one patient with–acute intestinal obstruction and sepsis, died.Conclusions: Morbidity and mortality of diaphragmaticruptures are mainly determined by associated injuries orcomplications of diaphragmatic herniation like incarcerationof viscera or lung failure. Early diagnosis helps to preventsevere complications. Laparotomy is an adequate surgicalapproach for diaphragmatic repair.
ABSTRACT
Background: RHD is a chronic heart condition caused by rheumatic fever. RHD is a disease affecting predominantly those living in poverty with inadequate access to health care and unchecked exposure to group A streptococcus. Aim: This study was carried out in our tertiary level hospital to study the magnitude of RHD in the overall cardiac outpatients and inpatients and the spectrum of cardiac involvement with complications and outcome after surgery. Material and methods: Present study was hospital based cross-sectional study over a period of 22 months at Department of Cardiothoracic Surgery including 39 patients with clinical and echocardiographic evidence of definite rheumatic heart disease and underwent valve repair. Information obtained included age, gender, names of referring hospital/physician, clinical diagnosis and echocardiographic findings. Results: 20 -30 years of age group was most affected age group following 31-40 years most of the people were between 20-40 years. Male to female ratio was around 1:1.7 showing female predominance. Most of the patients in study were with shortness of breath. Mitral stenosis was the commonest echocardiographic diagnosis present in 22(56.41%) following Mitral regurgitation was 9(23.07%) of the patients, 25(64.1%) patients had secondary pulmonary hypertension. After surgical procedure for RHD-related disease, deaths reported by RHD-related valve repair 2 (5%). Conclusion: Valve replacement is usually necessary, and they have good outcomes even if they are operated with severe regurgitation or stenosis.
ABSTRACT
A 35-year-old, human immunodeficiency virus sero-positive male presented with huge mediastinal mass for evaluation. After contrast enhanced computed tomography (CECT) angiogram, aneurysm of arch of aorta was diagnosed. The patient also proved to be co-infected with syphilis, which is the aetiological cause of aneurysm in this case. The present report highlights the need to suspect, diagnose and treat dual infections in individuals with high risk behaviour.