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Aim To assess the hemodilution during mitral valve surgery performed using St Thomas cardioplegia versus Del Nido cardioplegia. We also compared the volume of cardioplegia required, cross clamp time and cardiopulmonary bypass (CPB) time in each group. Methods and Materials Patients admitted between the period of January 2015 to June 2018 for mitral valve disease were included in this retrospective study. Patients were divided into two groups each comprising of 50 patients according to type of cardioplegia received during surgery. Results The hemodilution was much lesser in the patients who underwent mitral valve surgery using St Thomas cardioplegia (Haematocrit 26.3 ± 2.5%) as compared to those patients underwent the same surgery using del Nido Cardioplegia (Haematocrit 24.8 ± 2.2%). The volume of cardioplegia, cross clamp time and cardiopulmonary bypass time was less with del Nido cardioplegia as compared to St. Thomas cardioplegia (922.6 ± 95.4 vs 1854 ± 228.1 ml; 65.5 ± 8.2 vs 71.52 ± 8.8 minutes and 99.3 ± 13.1 vs 110.6 ± 14.6 minutes respectively). Conclusion The use of St Thomas Cardioplegia in patients during mitral valve replacement surgery has less hemodilution on CPB as compared to del Nido cardioplegia. But the patients who received del Nido cardioplegia has less requirement of number and volume of cardioplegia required during surgery with shorter cross clamp and CPB time
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Background: Purpura fulminans and bilateral perinatal testicular torsion are rare and may co-exist. Case characteristics: A 3-day-old neonate with bilateral swelling of scrotum; torsion and gangrenous changes were observed on exploration. Interventions: Left orchidectomy with preservation of right testis was done. Outcome: At 2-month follow-up, right testis showed signs of atrophy. Child developed full thickness skin lesions and died of sepsis. Message: Perinatal testicular torsion can be bilateral, and requires urgent surgical exploration.
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Congenital scaphoid megalourethera is described in two infants presented with abnormal large, flabby phallus and postvoiding dribbling of urine. MCU showed crescentric dilatation of penile urethra without any proximal or distal obstruction. A thorough evaluation suggested absence of any associated anomalies. Nesbitt's urethroplasty reinforced with dartos pedicle flap resulted in a satisfactory recovery. Authors review their experience with this modified surgical repair and the pertinent literature.
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BACKGROUND: Diarrhoea is a common clinical manifestation of HIV infection regardless of whether or not patients have AIDS. Two newly recognized opportunistic coccidial protozoa are parasitic pathogens in AIDS patients. We attempted to determine the common parasites in Indian patients with AIDS. METHODS: Between October 1994 and December 1996, a total of 110 stool specimens from 94 AIDS patients with acute or chronic diarrhoea were examined by microscopy of wet mounts and smears stained by a modified Ziehl-Neelsen's (cold) staining method. RESULTS: Isospora belli was the most frequently encountered parasite in 17% of patients, followed by Entamoeba histolytica in 14.9% and Cryptosporidium in 8.5%. Strongyloides stercoralis and Giardia lamblia were detected in 5.3% and 4.3% of patients, respectively. CONCLUSION: The presence of different parasites in 56.4% of stool specimens of patients with AIDS indicates that their specific diagnosis is essential. This will help initiate therapy to reduce the morbidity and mortality among such patients due to these pathogens.