Safe leg surgery: the anatomic principles and techniques

The goals of surgical treatment of leg injury are to achieve soft tissue healing, good osseous union and to restore the length of the limb, correct alignment of both bones with their respective joints and normal range of movements of the entire limb at the earliest. Presently, the surgical treatment has been standardised for the tibia fractures for adults and children. Though the surgical progress made in the implants, instruments and techniques, there are considerable surgical complications happening. This article highlights the need of anatomical expertise and safe operative ability for the surgeon.

A comparative study of low doses of intrathecal ketamine and midazolam with bupivacaine for postoperative analgesia in infraumbilical surgeries

Background: Infra-umbilical surgeries may be performed under local, regional (spinal or epidural) or general anaesthesia, spinal block is still a first choice, because of its rapid onset, high quality of blockade, lack of catheter related infection, less failure rate and also cost effective but the duration of block and postoperative analgesia is limited. The purpose of study was to compare the efficacy of adding ketamine to 0.5% hyperbaric bupivacaine with midazolam to 0.5% hyperbaric bupivacaine in elective infraumbilical procedures.Methods: A randomized, single blinded, clinical study. 60 subjects were enrolled from the patients presenting for elective infraumbilical surgeries after following the inclusion and exclusion criteria laid down for the study. Sixty ASA Grade I and II patients undergoing infra umbilical surgeries were randomly divided into one of the two equal groups (n=30).Results: Total 60 patients were included in this study. The mean time to achieve T10 sensory level and modified bromage scale III was prolonged in group M (4.33±1.09, 6.66±1.26 min) as compared to group K (3.3±0.7, 4.96±1.21 min) which was statistically significant (P value <0.05).Conclusions: The present study concludes that addition of intrathecal midazolam to hyperbaric bupivacaine provide very good and prolonged post-operative analgesia without significant intra-operative and post-operative side effects compared to intrathecal ketamine.

Odontogenic Keratocyst of Maxillary Premolar Region: A Case Report.

Odontogenic keratocysts (OKC) are enamel organ or dental lamina derived cysts and are not thought to be associated with any infection. They mainly occur in second and third decades of life. The purpose of this case report is to describe a rare case of OKC in a 10-year-old girl, associated with upper left unerupted maxillary first premolar. It involved maxillary sinus leading to erosion of left orbital floor. It also led to the displacement of adjacent maxillary canine and maxillary left second premolar above the unerupted maxillary left third molar. Due to the aggressive nature of the cyst, it was enucleated and followed-up.

Ameloglyphic, Dermatoglyphic, Sweat Pore Analysis of Hidrotic Ectodermal Dysplasia: A Rare Case Report.

Hidrotic ectodermal dysplasia (ED) is an autosomal dominant genetic disorder characterized by the triad of features such as nail dystrophy, generalized hypotrichosis, and palmoplantar hyperkeratosis. Physical development and life expectancy are not affected. Dermatoglyphics and ameloglyphics have been considered as casement of congenital abnormalities and other conditions. Young adults and children with hidrotic ED need to be evaluated early by a dentist to determine the oral outcome. Stipulated, appropriate care needs to be provided throughout the child’s growth to maintain oral function. According to this study ameloglyphics was found to be beneficial over dermatoglyphics in timely diagnosis and treatment planning.

Hepatoprotective activity of Ficus carica Linn. leaf extract against carbon tetrachloride-induced hepatotoxicity in rats

The methanol extract of the leaves of Ficus carica Linn. [Moraceae] was evaluated for hepatoprotective activity in rats with liver damage induced by carbon tetrachloride. The extract at an oral dose of 500 mg/kg exhibited a significant protective effect by lowering the serum levels of aspartate aminotransferase, alanine aminotransferase, total serum bilirubin, and malondialdehyde equivalent, an index of lipid peroxidation of the liver. These biochemical observations were supplemented by histopathological examination of liver sections. The activity of extract was also comparable to that of silymarin, a known hepatoprotective

SARS: the new challenge to international health and travel medicine

Severe acute respiratory syndrome [SARS], the first severe new infectious disease of this millennium, caused widespread public disruption. By July 2003, 8427 probable SARS cases had been reported from 29 countries with a case fatality rate of 9.6%. The new febrile respiratory illness spread around the world along the routes of international air travel, with outbreaks concentrated in transportation hubs or densely populated areas. The etiologic agent was identified as a novel coronavirus, SARS-CoV. The disease is transmissible person-to-person through direct contact, large droplet contact and indirect contact from fomites and unwashed h and s. Saudi Arabia successfully prevented the entry of the disease by imposing travel restrictions, special entry requirements, screening procedures at airports, including temperature checks, and quarantine. Ongoing efforts are aimed at developing case investigation, case management and surveillance protocols for SARS