Right-sided diaphragmatic eventration: A rare entity.

Eventration of the diaphragm is an abnormal elevation of the dome of diaphragm. It is a condition in which all or part of the diaphragm is largely composed of fibrous tissue with only a few or no interspersed muscle fibers. It can be complete or partial. Complete eventration of the right diaphragm, as seen in this adult patient, is relatively rare.

Intracavernous papaverine for impotence in spinal cord injured patients.

The majority of the spinal cord injury patients in our centre are young healthy males aged between 20 and 40 years. Loss of erection and inability to have coitus and father children have been responsible for inadequate sociosexual rehabilitation. In 1985, under urologist supervision, intracavernosal papaverine injection treatment was started in 101 volunteers, 65 paraplegics and 36 tetraplegics. Satisfactory erection sufficient for coital penetration was possible in 98 patients. Three had prolonged erection lasting beyond 4 hours. Only one required irrigation of the corpus with saline to achieve detumscence. One patient developed cavernosal fibrosis necessitating discontinuing the injection. Administration was under medical supervision so that possible complications of priapism/systemic effects could be promptly managed.

Indian spinal injuries centre.

A 110-bedded spinal injury centre is under construction in New Delhi. This centre will be equipped through Indo-Italian friendship with the latest medical and technical equipment. The centre will be ready in September 1992 for the treatment of acute injuries from Delhi and surrounding areas and will treat complicated cases referred by other centres/hospitals in India. Research and training of doctors, nurses and rehabilitation staff will be an integral part of the centre.

Lumbar canal stenosis.

Lumbar canal stenosis has been well recognised as a cause of low backache. A study was undertaken to find out the incidence of lumbar canal stenosis in Indian adults from 1 July 1978 to 30 June 1981. The diagnosis was based on clinical, radiological and myelographic findings. The majority of adults in the fourth decade were found to be suffering from degenerative arthritis of the apophyseal joints with thickened ligamentum flavum. Congenital stenosis cases were few. Decompression of the stenosed canal by laminectomy of the stenosed segments and excision of thickened ligamentum flavum, or any osseous element in the posterolateral compartment, gave lasting relief from backache and intermittent claudication. Incidence of pure relative stenosis is higher than pure absolute stenosis amongst Indian adults.

The radical treatment of tuberculosis of the spine.

The technique of radical treatment of tuberculosis of the spine at various levels is described. Eighty cases out of 158 of spinal caries underwent radical surgery over a period of 7 years. Caseous pus, sequestra, granulation tissue and discs were excised. Rib grafts were used in the dorsal spine and iliac strut grafts in the cervical and lumbar spine, through a direct anterior approach. Sound bony fusion was achieved in 90% of cases. The procedure is technically difficult but recovery is fast and the majority were fit to resume work within 6 months.

Care of spinal cord in the armed forces of India.

Development of Spinal Cord Injuries Centre in the Armed Forces of India has been discussed. Starting from a 30-bedded unit in 1965 we have now a 100-bedded spinal cord injury centre, a major rehabilitation centre managed by trained medical staff for these patients. A 25-bedded paraplegic home for ex-servicemen has been recently built with modern facilities and amenities. Medical rehabilitation and vocational services are now available to paraplegics in a radius of one kilometre at this centre.