Forequarter amputation for open scapulothoracic dissociation: A case report and surgical technique.

Scapulothoracic dissociation is a rare upper extremity injury caused by high-velocity trauma over anterolateral shoulder leading to disruption of scapulothoracic articulation. It is considered as a limb threatening injury. Very few cases of scapulothoracic dissociation have been reported in medical literature. In this article, we report a unique case of open injury involving laterally displaced and comminuted scapula accompanied by redundant acromioclavicular joint, total brachial plexus injury, and complete transection of brachial artery. The patient underwent a forequarter amputation after a failed vascular repair.

Epidemiological and clinical characteristics of central nervous system infections in a tertiary center: A retrospective study.

Background and Aims: Central nervous system (CNS) infection is one of the most common causes of morbidity, mortality, and hospital admission worldwide. The natural history of CNS infection is quite fatal. Early diagnosis and treatment have been proven to have a crucial role in patients' survival. The aim of this study was to identify the epidemiological and clinical patterns of patients diagnosed with CNS infections. Methods: This study is a retrospective study conducted in a tertiary level hospital in Nepal in which patient diagnosed with CNS infections (September 2019 to 2021) were included. Data were collected and analyzed in SPSS. Results: The mean age of the 95 patients included in the study was 45.18 ± 19.56. Meningoencephalitis (n = 44, 46.30%) was the most common infection diagnosed. Patients belonging to the age group 30-60 years had a higher frequency of focal neurological deficit, and other classical clinical features. All the patients who died during the treatment had associated comorbidities but no concurrent infections. Altered sensorium, fever, and headache were the common presenting symptoms in all the recovered patients. Conclusion: To ensure optimum disease outcome, early diagnosis and prompt management are crucial. For this, recognizing the local disease patterns in terms of disease distribution, commonly implicated aetiologies, presenting symptoms, and prognostic factors is of utmost importance.