ABSTRACT
Arterial cannulation is routinely performed in children undergoing cardiac surgery to aid the intraoperative and intensive care management. Most commonly cannulated peripheral site in children is radial artery, and alternatives include posterior tibial, dorsalis pedis, and rarely superficial temporal artery (STA). Two specific situations in cardiac surgery where STA cannulation and monitoring was useful during the surgical procedure are reported. To our knowledge, such selective use of STA pressure monitoring has not been reported in the literature previously. Our experience suggests that STA monitoring can be useful and reliable during repair of coarctation of aorta or administration of anterograde cerebral perfusion in patients having associated aberrant origin of the right subclavian artery.
ABSTRACT
The aim of this study was to evaluate the trans-axillary surgical approach in patients with thoracic outlet syndrome. This retrospective study is comprised of data acquired from January 1998 until Oct 2008. Case histories of all the patients were reviewed from the Medical Records Department of Sher-i-Kashmir Institute. Relevant information and follow-up of the patients was carried out by examining the relevant clinical notes available by telephone interviews and personal contact whenever possible. All data was compiled and analyzed statistically. There were a total of 139 patients. The female: male ratio was about 6:1. Pain was the most common presenting symptom followed by weakness and parasthesia. Nerve conduction velocity was abnormal in 111 patients. Twenty-eight patients had abnormal Doppler study of subclavian vessels. Preoperative symptoms persisted in 13 patients. Overall, 126 patients showed improvement in symptoms and no recurrence or persistence of symptoms on follow-up examination. Trans-axillary approach provides a good exposure and cosmesis in patients with thoracic outlet syndrome. It should be considered as the gold standard in the management of thoracic outlet syndrome
Subject(s)
Humans , Female , Male , Axilla , Decompression, Surgical , Retrospective Studies , Tertiary Care Centers , PainABSTRACT
To evaluate the effect of parenteral testosterone on penile length, preputial skin and side effects in patients with hypospadias. 23 patients with hypospadias were included in this study. An oily solution, each ml of which contained testosterone propionate 25 mg, and testosterone enanthate 110 mg, equivalent to 100 mg of testosterone was given deep intramuscularly 4, 3 and 2 weeks before reconstructive surgery at the dose of 2 mg/kg body weight. Increase in penile length, transverse preputial diameter, and diameter at the base of penis were noted. Basal testosterone levels were obtained before the institution of therapy and on the day of operation. In addition, side effect such as development of pubic hair and delay in bone age was noted. Following parenteral testosterone administration, the mean increase in penile length, transverse preputial diameter and diameter at the base of penis was 1.35 +/- 0.40 cm [P<0.001], 1.40 +/- 0.47 cm [P<0.001], and 0.72 +/- 0.47 cm [P<0.001], respectively. Serum testosterone level after injection was well within normal range for that age. Minimal side effects were noted in form of development of fine pubic hair. We conclude that parenteral testosterone can be safely used to improve the surgical outcome of hypospadias repair
ABSTRACT
This study was designed to evaluate the possible complications following the use of intraoperative mitomycin-C in patients undergoing surgery for primary pterygium. Hundred eyes of 88 patients with primary pterygium were operated upon using ''bare sclera technique''. Intraoperatively all the patients were applied freshly prepared mitomycin-C 0.02% (0.2 mg/ml) on the bare sclera for a period of 5 minutes, after which the eyes were thoroughly rinsed with a sterile balanced salt solution. Postoperatively, none of the patients recieved mitomycin-C eye drops. After a mean postoperative followup of 14 months, 4 eyes (4%) of 4 patients developed thinning of the sclera with visualization of the underlying uveal tissue. One eye (1%) developed extreme thinning of the sclera with ectasia of the underlying uveal tissue, requiring a scleral patch. Recurrence was seen in 2 eyes (2%) only. The study shows that although intraoperative mitomycin-C (0.02%) reduces the recurrence of pterygium, it leads to serious, cosmetically unacceptable and even sight-threatening complications.
ABSTRACT
We present a rare case or bee-sting to the cornea which leads to a variety of changes involving the anterior segment of the eye.
ABSTRACT
To compare the ocular hypotensive efficacy and side effects of either latanoprost or dorzolamide in patients with open angle glaucoma, forty-four patients with open angle glaucoma were included in a randomized, double masked study for a period of 3 months. All previous glaucoma medications were stopped and the patients were randomized to receive either latanoprost 0.005% at bed time or dorzolamide 2% three times daily. After 3 months, the mean reduction in rap was 6.8 (SD 3.1) mm Hg in the latanoprost group as compared to 4.7 (SD 2.4) mm Hg in the dorzolamide group. The difference of 2.1 nun Hg was highly significant. Both the drugs were well tolerated systemically and locally. Latanoprost was superior to dorzolamide in reducing the mean lOP and thus has the potential for becoming the first line treatment in glaucoma.
ABSTRACT
This study was undertaken to evaluate the long term results 0f intraoperative mitomyc in C appIication in dacryocystorh inostomy (DCR) surgery compared WIith results of the conventiona I procedure. In this prospect were randomly controlled study, a totaI 0f 44 eyes diagnosed with acqu ired nasolacrimal duct obstruction were randomly divided into a conventional DCR group and a mitomyein C group in which mitomycin C was used during DCR surgery. The surgical procedures in both groups were exactly the same. except that in the patients in the mitomycin C group, a piece of neurosurgical cottonoid soaked with 0.2 mg/ml mitomycin C was applied to the osteotom) site for 30 minutes. The results of the DCR surgeries were evaluated by objective findings such as irrigation and the height of tear meniscus and subjective symptoms like condition of tearing Among the 22 eyes in the I n C grou p. 95.45% of patients remained totally symptom free after 9 months 0f follow up; while in the conventional group. 72.72% o("patients were reported to be symptom free and 18% 01" patients to have all improvement ill their symptoms. There was a significant difference between these h\o groups. As far as objective findings were concerned. there were 21 eyes in the mitomycin C group classified as having normal and one eye with moderate tear meniscus level. compared with 16 eyes and 3 eyes. respectivel), in the conventional group. There was also a significant difference between these two groups. The non-patency rate in the mitomycin C group was 4.50/0 compared with II A% in the conventional group. There were no complications such as abnormal nasal bleeding. Thus lucosalnecrosis or infection except one patient with delayed wound healing. Thus intraoperative mitomycin C application was effective in increasing the success rate of DCR surgery in standard nasolarcimal duct obstruction and no significant complications resulted from its use.