Transthoracic repair of diaphragmatic hiatus hernia with esophageal shortening where laparoscopic abdominal approach does not give satisfactory results.

A 50 year old female patient presented with history of regurgitation of food, heart burn, dyspepsia. Patient was investigated and presence of large hiatus hernia was confirmed on endoscopy, computed tomogram chest and barium swallow. Patient had severe symptoms even with maximum medical management, therefore surgical intervention was planned. Left posterolateral thoracotomy was done through sixth intercostal space. Mobilization of esophagus, reduction of stomach and Belsey Mark IV 270 degree anterolateral fundoplication was done. Patient was discharged on 7th postoperative day. First follow up was I month after the discharge and patient had significant relief from the preoperative problems.

Interventions for primary (intrinsic) tracheomalacia in children

Tracheomalacia, a disorder of the large airways where the trachea is deformed or malformed during respiration, is commonly seen in tertiary paediatric practice. It is associated with a wide spectrum of respiratory symptoms from life-threatening recurrent apnoea to common respiratory symptoms such as chronic cough and wheeze. Current practice following diagnosis of tracheomalacia includes medical approaches aimed at reducing associated symptoms of tracheomalacia, ventilation modalities of continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP), and surgical approaches aimed at improving the calibre of the airway (airway stenting, aortopexy, tracheopexy).

To evaluate the efficacy of medical and surgical therapies for children with intrinsic (primary) tracheomalacia.

The Cochrane Airways Group searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Airways Group's Specialized Register, Medline and Embase databases. The Cochrane Airways Group performed the latest searches in March 2012.

All randomized controlled trials (RCTs) of therapies related to symptoms associated with primary or intrinsic tracheomalacia.

Two reviewers extracted data from the included study independently and resolved disagreements by consensus.

We included one RCT that compared nebulized recombinant human deoxyribonuclease (rhDNase) with placebo in 40 children with airway malacia and a respiratory tract infection. We assessed it to be a RCT with ...

Maturation of permanent teeth in different facial types: A comparative study.

Background: Accurate diagnosis of dental maturation help in diagnosis, treatment planning, and timing in orthodontics and dentofacial orthopedics. Aim and Objective: The present study is undertaken to compare and correlate chronological age and dental age of patients with average, vertical, and horizontal facial types, and to find out any sex difference in dental age in different growth patterns and to evaluated the reliability of Willem's method in Indian population. Materials and Methods: Subjects in the age group of 8-10 years were screened from Out Patients Department of Orthodontics and Dentofacial Orthopedics and from the various school of the City, were subjected to cephalometric radiography and orthopentomograms. Angular and linear measurements used included;-SN Go-Gn angle, J.R. (Jarabak ratio) and LAFH (lower anterior facial height), to group total sample of 150 children. Group 1 (average grower), Group 2 (vertical grower), and Group 3 (horizontal grower). Then dental age for each child in different group was calculated from OPG of each subject and compared with chronological age using Student t-test. Results: The results suggest a difference in dental age in subject with vertical and horizontal growers. Vertical grower showed earlier maturation compared to horizontal growth patterns. There was insignificant difference present when vertical grower and horizontal grower were compared with average growth pattern. Insignificant difference was found in dental age between males and females when compared to same growth pattern. Conclusion: Subjects with vertical growth pattern matured early than having the horizontal growth pattern in the same chronological age.

Does preoperative biliary stenting affect the outcome of pancreatico-duodenectomy?

BACKGROUND: Controversy exists whether preoperative endoscopic biliary stenting to reduce serum bilirubin level affects the outcome of pancreaticoduodenectomy. AIM: To determine whether preoperative endoscopic biliary stenting is associated with altered morbidity or mortality after pancreaticoduodenectomy. METHODS: In 37 consecutive patients with periampullary lesion undergoing pancreaticoduodenectomy over a 6-year period, frequency of septic complications, occurrence of pancreatic leak or bleeding, duration of hospital stay, and mortality were studied; of these, 15 had preoperative biliary stenting and 22 had not. RESULTS: Postoperative infective complications occurred more often in the patients with biliary stent than in those without (26% vs 0%, p=0.04). Postoperative recovery time, hospital stay and mortality were similar in the two groups. CONCLUSION: Preoperative biliary stenting is associated with septic complications, but this does not affect postoperative recovery after pancreaticoduodenectomy.