Rehabilitation of orbital defect with silicone orbital prosthesis retained by dental implants.

Orbital defects can result from cancer, birth anomalies, or trauma leading to an onslaught of problems in the function and psyche of the patient. These defects are restored by surgical reconstruction and followed by placement of orbital prosthesis for cosmetic makeup. The use of dental implants in retaining orbital prosthesis improves patient acceptance of the prosthesis owing to better retention and stability than conventional adhesive retained prosthesis. This case report describes a custom‑made magnetic retentive assembly anchored by a dental implant which offers the orbital prosthesis the simplicity of self‑alignment and ease of use.

Clinicoradiological correlation in birth asphyxia.

Background: Hypoxic Ischemic Encephalopathy (HIE) is the most dreaded neurological disease of the new-born. Assessment of severity of HIE would help proper parent counseling and early institution of stimulation therapy for better development of the infant. Methods: This study was conducted between December 2012 and May 2014. 37 term neonates with perinatal asphyxia were the subjects. The cranial ultrasound, EEG and MRI findings of these babies are analysed and correlated with each other and with clinical staging and the neurological condition of the babies at discharge. Results: Among the 37 neonates, 21 were of HIE stage 2 and 16 were of stage 3. Sensitivity of EEG in detecting abnormality in the neurological condition according to our study is 76.9%, specificity 87.5%, positive predictive value 76.9%, negative predictive value 87.5%. Sensitivity of severe pattern of injury in MRI brain in detecting abnormality in neurological condition according to our study is 76.9%, specificity 91.6%, positive predictive value 83.3%, negative predictive value 88%. Involvement of both basal ganglia and cortex in MRI brain had statistically significant correlation with abnormal neurological condition at discharge in our study (P = 0.04). Conclusion: An abnormal EEG and MRI brain in a term new-born with Hypoxic Ischemic Encephalopathy (HIE) is associated with poor neurological outcome. Involvement of basal ganglia/thalamus and cortex together in the MRI are predictors of abnormal outcome.

Study on site of acute myocardial infarction associated with arrhythmias and outcome.

Despite considerable progress, Arrhythmias remain a major cause of death in patients with myocardial infarction. Majority of these arrhythmias occurring within the first 24 hours. Few studies have shown that, frequently associated different arrhythmias with various distributions of myocardial infarctions. The aim of the present study is to identify the type of arrhythmias and outcome in patients presenting with acute myocardial infarction. Methods: A total of 100 patients admitted to the ICC unit of govt. general hospital, Gulburga & Basaveshwar teaching & general hospital Gulburga from one year data were taken for present study. The risk factors for cardiac disease were evaluated through history, physical examination and blood investigations. All the patients were monitored for 48-72 hours for arrhythmias. Type and time of onset arrhythmias was also noted. Results: Out of the 100 patients with myocardial infarction studied, 76 patients had arrhythmias. Majority of arrhythmias occurred during less than 12 hours and sinus tachycardia was the commonest arrhythmia (40%). The overall incidence of mortality was 15%. Majority of mortality occurs with 24 hours (66.6%). Mortality was more in males (16.25%) than female (10%). Cardiogenic shock (40%) and left ventricular failure (33.33%) were the most common cause of death. Conclusions: Arrhythmia occurred in 76% of the patients with acute myocardial infarction. Sinus tachycardia was the most common arrhythmia constituting about 40% of patients who had arrhythmias.

Incidence of Arrhythmias in Myocardial Infarction.

Background: Acute myocardial infarction remains a major health problem. The deaths with acute myocardial infarction are believed to occur within first 24 hours after myocardial infarction and are attributed to arrhythmias. The objective of this study is to assess incidence of arrhythmias in myocardial infarction and to time of their onset in patients presenting with myocardial infarction. Methods: 100 patients with acute myocardial infarction admitted to the ICC unit of Govt. General Hospital, Gulburga & Basaveshwar Teaching & General Hospital Gulburga from one year data were taken for present study. A detailed case history was taken and a meticulous physical examination was done for each patients. This was recorded in a proforma at the time of admission, detailed history, physical examination, ECG changes, echocardiography and serum enzyme levels. Time of onset and type of arrhythmias was also noted. Results: Male to female ratio with 4:1, mortality was more in the group with risk factors of smoking, Hypercholesterolemia, hypertension and diabetes. Commonest arrhythmias noticed in this study were ST-40%, VPBs – 35%, AVB-22%, BBB -20%, SB-15%, and VT -10%. Out of the 100 patients with myocardial infarction studied, 76 patients had arrhythmias. Majority of arrhythmias occurred during less than 12 hours and Sinus tachycardia was the commonest arrhythmia (40%). Conclusion: The commonest arrhythmias encountered were sinus tachycardia followed by ventricular premature beats, AV blocks, bundle branch block, sinus bradycardia and ventricular tachycardia. SB & Complete heart block were more common in IWMI whereas ST, VPC, and UB f were more common with AWMI. In addition to arrhythmias, Cardiogenic shock added to the mortality. 51% of patients developed arrhythmias in one or the other form within 24 hours of admission.

Study on Site of Acute Myocardial Infarction Associated With Arrhythmias and Outcome.

Background: Despite considerable progress, Arrhythmias remain a major cause of death in patients with myocardial infarction. Majority of these arrhythmias occurring within the first 24 hours. Few studies have shown that, frequently associated different arrhythmias with various distributions of myocardial infarctions. The aim of the present study is to identify the type of arrhythmias and outcome in patients presenting with acute myocardial infarction. Methods: A total of 100 patients admitted to the ICC unit of Govt. General Hospital, Gulbarga & Basaveshwar Teaching & General Hospital Gulbarga from one year data were taken for present study. The risk factors for cardiac disease were evaluated through history, physical examination and blood investigations. All the patients were monitored for 48-72 hours for arrhythmias. Type and time of onset arrhythmias was also noted. Results: Out of the 100 patients with myocardial infarction studied, 76 patients had arrhythmias. Majority of arrhythmias occurred during less than 12 hours and Sinus tachycardia was the commonest arrhythmia (40%). The overall incidence of mortality was 15%. Majority of mortality occurs with 24 hrs (66.6%). Mortality was more in males (16.25%) than female (10%). Caridogenic shock (40%) and left ventricular failure (33.33%) were the most common cause of death.

Anesthetic management of a patient with bicuspid aortic valve and Hashimoto's thyroiditis posted for abdominal hysterectomy.

Bicuspid aortic valve is the most common birth defect affecting the heart and is present in 1-2% of the population. The abnormal valve structure leads to turbulent flow, fibrosis, calcification, and aortic stenosis. Aortic stenosis increases perioperative morbidity and mortality. Anesthetic techniques that reduce systemic vascular resistance (regional neuraxial techniques) must be used with extreme caution. Hashimoto's disease or chronic thyroiditis or autoimmune thyroiditis is the most common cause of hypothyroidism in adults. Regional anesthesia is preferred in patients with hypothyroidism as recovery from general anesthesia may be delayed by hypothermia, respiratory depression, or slow drug biotransformation. This is a case report of anesthetic management of a middle-aged female with co-existing aortic stenosis, hypothyroidism, and fibroid uterus posted for abdominal hysterectomy.