Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation.

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fi xed to the pars plana at both 3 and 9 o’clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and eff ective surgical option for such cases.

effect of slow coronary flow on right and left ventricular performance

To evaluate left and right ventricular functions using tissue Doppler echocardiography [TDE] and myocardial performance index [MPI] methods in patients with slow coronary flow [SCF] and to determine the relationship between these parameters and thrombolysis in myocardial infarction frame count in SCF patients. Thirty-five patients [20 males and 15 females] with SCF who underwent coronary angiography and 35 age- and sex-matched controls [14 males and 21 females] without SCF who underwent elective coronary angiography were enrolled in the study. Left ventricular [LV] and right ventricular [RV] functions were examined using conventional echocardiography and TDE. LV systolic myocardial velocity [Sm], early myocardial velocity [Em], late myocardial velocity [Am], and Em/Am ratio were similar in both the SCF and control groups; however, isovolumetric relaxation time [IRT] was higher in the SCF group compared to the control group [IRT: 99 +/- 17 vs. 88 +/- 20; p = 0.01]. In patients with SCF, LV MPI was higher than in the control group, but this was not statistically significant [0.61 +/- 0.11 vs. 0.56 +/- 0.12; p = 0.07]. The RV tricuspid annular velocities and MPI were similar in the SCF and control groups. This study showed that SCF affected LV functions echocardiographically and could cause partially reduced LV performance. In addition, SCF did not affect RV functions echocardiographically

Interlocking nailing of humeral shaft fractures. A retrospective study of 114 patients.

BACKGROUND: Fractures of the humeral shaft are relatively common injuries. Literature suggests that humeral shaft fractures represent approximately 3 % of all fractures. There are several modalities for the management of diaphyseal humeral fractures. The latest investigations emphasize the concept of minimal exposure and rigid fixation. AIM: The aim of the study is to evaluate the results of antegrade intramedullary nailing in humeral shaft fractures. DESIGN: A retrospective review. SETTINGS: Patients were treated in private hospital settings by 3 orthopaedics surgeon. MATERIAL AND METHODS: Between 1995 and 2003, the technique of antegrade locked intramedullary nailing with UHN in humeral shaft fractures was performed on 114 patients. Forty-two (36%) patients sustained multiple traumas, and 22 (19%) fractures were open. The outcomes were evaluated with a mean follow-up of 41 months. STATISTICAL ANALYSIS USED: Ranges of results given. RESULTS: In 109 fractures primary union observed. In the other five patients union achieved after removal of the nail and fixation with DCP and bone grafting. The average time for union was 13 weeks (range, 10-36 weeks). One hundred-five patients had excellent or satisfactory recovery of shoulder and elbow function. Complications included impingement due to proximal locking screws in two patients and prominent nail in three patients, transient postoperative radial nerve palsy in four patients. CONCLUSIONS: This study shows that antegrade locked nailing in humeral shaft fractures are reliable and also effective in multiply injured patients.

Audiovestibular system, fifth and seventh cranial nerve involvement in leprosy.

Thirty-nine patients with leprosy and fifteen sex- and age-matched controls were investigated for disorders of the fifth and seventh cranial nerves and that of the audiovestibular system. Sensorineural hearing loss found to be of cochlear origin was detected in eight (22%) of the patients with leprosy compared to none in the control group (p > 0.05). Vestibular dysfunction was noted in four patients (11.1%) compared to none in the control group (p < or = 0.05). Two cases were found to have fifth nerve involvement and one (2.8%) had seventh nerve involvement. None in the control group had fifth or seventh nerve deficit.