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Background: The Titanium Elastic Nail is mostly used in children to treat diaphyseal and metaphyseal fractures. The age of the patient, as well as the nature and location of the fracture, determine if the TEN is necessary. In some situations of femoral diaphyseal fractures, it is a successful and realistic therapeutic choice. The TEN allows for elastically stable intramedullary nailing. In terms of patient and parent happiness, as well as shorter confinement to bed and hospital stay, open reduction can produce a significantly better outcome than traction and spica cast or any other treatment. The aim of the study was to observe Titanium Elastic Nailing for treatment of femoral shaft fractures.Material & Methods:This observational study was conducted at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Bangladesh. The study duration was 2 years and 8 months, from April 2019 to December 2021. The study was conducted with a total of 40 cases of femoral shaft fracture in pediatric patients who were admitted to the study hospital.Results:Male prevalence was observed in the present study, with 3.44:1 male: female ratio. Mean±SD age of the participants was 8.8 ± 1.6 years, and sports injuries were the most common cause of fractures. 72.5% of the participants were aged between 5-10 years, and the age range of the participants was 5-13 years. 50% of the participants had fractures at the middle region of the femur, while 45% had fractures at the proximal region. Mean±SD hospital stay duration was 14.5 ± 2.4 days, with 62.58% having hospital stay between 7-14 days. Majority of the participants of the present study faced no complications, while 20% had <1.0 cm of leg length inequality, 2.5% had 1-2 cm leg length inequality, 2.5% faced infection, 5% faced entry site irritation and 1 patient had soft tissue irritation by prominent nail. At 12-monthg follow up, 75% had excellent outcomes while 20% had satisfactory outcomes.Conclusions:The titanium elastic nailing is an effective and viable treatment option in selected cases of femoral shaft fractures in the 5-13 years’ age group. Even if it is done by open reduction it gives much better result than traction & Spica cast or any other methods, in respect to patient & parent’s satisfaction & shorter confinement to bed & hospital stay.
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Background: Presence of H. pylori infection was found associated with peptic perforation and gastric carcinoma. Present study tried to estimate the prevalence of H. pylori infection in those patients and to find out the correlates of H. pylori infection.Methods: After matching the inclusion and exclusion criteria, all cases of diagnosed peptic perforation and gastric carcinoma were taken for this prospective, single center, observational study.Results: Among the study population, gastric carcinoma was found in higher age group; whereas peptic perforation was found in lower age group; male and female ratio was 2:1 in both groups of patient. Laborer and housewives were mostly affected in both cases. Gastric carcinoma was more prevalent in urban residents, opposite was seen in peptic perforation. Most patients in two groups had no previous co-morbid condition. Use of NSAIDs was found in high frequency in both groups. Most of the patients were chronic alcoholic and chronic smoker, and most of them had history of taking spicy foods more than twice in a week.Conclusions: H. pylori infection was found in high frequency in both group of patients, and it was higher in peptic perforation. The study establishes the association of H. pylori with the gastric carcinoma and peptic perforation.
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Takotsubo cardiomyopathy or stress-induced cardiomyopathy is a cardiac syndrome of a reversible, transient left ventricular dysfunction that is caused by emotional and/or physical stress and surgery. Its clinical manifestations are similar to acute myocardial ischemia in absence of coronary artery lesion. It is more common in middle-aged women, and the prognosis is favourable. We report the case of a 32-year-old male patient who underwent a total colectomy, developed stress-induced cardiomyopathy and had poor outcome despite extracorporeal membrane oxygenation (ECMO).
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Goldman and colleagues identified severe aortic stenosis (AS) as a risk factor for perioperative cardiac complications in non-cardiac surgery. Although patients with aortic stenosis are at an increased risk of perioperative cardiac events, they can undergo non-cardiac surgery relatively safely provided that the condition is recognized and appropriate monitoring and management put in place. The early detection and treatment of hypotension and arrhythmias are essential. We present a case of severe aortic stenosis posted for emergency open cholecystectomy which was successfully managed under epidural anaesthesia and had an uneventful recovery.