Endotoxemia in patients with chronic liver disease

This study was conducted on 100 selected patients with chonic liver disease to find the relationship between plasma endotoxin level and the severity of liver disease. Twenty normal controls were in the study for Comparison. Patients were classified according to Child Classification into Child A group [30 Patients] and Child Band C groups [70 Patients]. Endotoxin level was assayed in the plasma of patients and controls using a quantitative chromogenic Limulus Amaebocyte Lysate Test [LAL]. The level of endotoxin was significantly in Child groups A, B and C than in the normal controls. Also it was found that the level of endotoxin in Child group B and C was significantly higher than in group A [P<0.05]. The endotoxin level was also significantly higher in cases with cirrhotic or mixed pattern than in those with schistosomal pattern [p=0.05]. It was found that the level of endotoxin correlated significantly with the incidence of ascites. It was concluded that endotoxaemia becomes more prominent with the progression of liver disease especially when associated with a mixed aetiology which may have its impact on the hepatic state and extrahepatic manifestationss

Rigid internal fixation in phalangeal hand fractures

Fifty-one patients with 64 recent fracture phalanges were treated with fixation using the mini fixation system of the ASIF group. There were 36 closed, and 28 open fractures. Fourty-two fractures were fixed with screws only, and twenty-two with mini plate and screws. Closed fractures fixed with screws gave 95.8% satisfactory results, while open fractures gave 61.1% satisfactory results. Closed fractures fixed with mini plate and screws gave 58.3% satisfactory results, while open fractures gave 10% satisfactory results

simple technique for treatment of acute mallet fingers

Fifty-eight patients with sixty-five acute mallet fingers were treated by internal splinting technique. 39 patients had closed injuries with 39 fingers involved, and 19 patients had open injuries with 26 fingers involved. No extensor tendon repair or external splinting were used in either open or closed injuries. In Type 1 mallet finger, closed injuries had 93.3% satisfactory results. In Type 2 mallet finger 85.7% had satisfactory results. Most of the patients have been able to go back to work within 3-10 days. We recommend local anaesthesia for this procedure. Thus, without hospitalization or external splinting this procedure provides a simple treatment for a minor lesion, a principle which should never be forgotten

K wire-bone cement external fixator device in certain open finger fractures

External fixatiors are useful when wounds prohibit internal fixation and bone comminution render the fracture difficult to control by other means. Since 1986 up till now 1988, fixation with K. wire-bone cement external fixator divice was performed on 49 open finger fractures. The overall results are satisfactory. This simple procedure requires no special instruments and it facilitates reduction of the fractures. It provides stable fixation, accessibility for wound care as well as fixation of the approximated cut extensor tendon ends allowing early mobilization

Tumours of the spinal canal

"There can be few greater satisfactions either to patient or surgeon than for a bed ridden, incontinent patient to take up his bed and walk, to have once more control of his sphincters and remain well for many years without recurrence of the tumour". Rogers [1955] on removal of spinal tumours. This is a study of 72 cases of tumours in relation to the spinal cord, removed during the last 15 years. The incidence and pathological types are presented and the literature reviewed. Intradural angiomatous malformations and extradural haemangiomata were discussed at some length as their incidence was high in our series. Stress has also been laid on the potential malignant nature of some extradural meningiomata encountered in this series. Certain tumours presented with unusual clinical features and some rare tumours were reported and discussed