International Journal of Recent Surgical and Medical Sciences最新文献

{"title":"Primary Sclerosing Cholangitis Pruritus Treated with Plasmapheresis","authors":"Katharine Tippins, Oyewale O. Shiyanbola, W. N. Rose","doi":"10.1055/s-0043-1761510","DOIUrl":"https://doi.org/10.1055/s-0043-1761510","url":null,"abstract":"Abstract Evidence regarding the efficacy of plasmapheresis for pruritus due to hepatobiliary disease is sparse. The mechanism of pruritus in this context is poorly understood. Some candidates for the offending agents are bile salts and histamine. Primary sclerosing cholangitis is one such disease and appears to have an autoimmune component. The rationale for plasmapheresis for patients who are refractory to medical therapy has some plausibility because the nonspecific nature of plasmapheresis may significantly decrease one or more of the offending substances in the patient's plasma. We share our experience of a patient with pruritus due to primary sclerosing cholangitis who benefited from plasmapheresis.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77929157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficult Bronchoscopy and Foreign Body Removal: Our Experience","authors":"P. S., N. Rb, G. K., Karthika Sr, R. S","doi":"10.1055/s-0043-1764365","DOIUrl":"https://doi.org/10.1055/s-0043-1764365","url":null,"abstract":"Abstract Background  Foreign body in the airway is the most life-threatening situation. Most foreign bodies present as acute emergency and can be removed by endoscopy/bronchoscopy, while a few causes complication of a retained foreign body which requires emergency tracheostomy to secure airway followed by foreign body removal. Case Presentation  We report our experience in the management of three children who required tracheostomy through which bronchoscope was introduced and foreign body removed. All patients with unrecognized retained foreign body presented with respiratory distress with desaturation. Imaging was suggestive of atelectasis. After foreign body removal patients recovered well and decannulated by day 5. Subglottis is the narrowest part of pediatric airway. As these foreign bodies were vegetative they are hygroscopic in nature and hence would not be able to remove the foreign body by bronchoscopic guidance. Hence, tracheostomy was done to provide access followed by bronchoscopic removal. Conclusion  Aspirated foreign body present challenges to the ear, nose, and throat surgeon. Newer techniques enable removal of foreign body easier. Tracheostomy combined with bronchoscopy can be a life-saving and easy to perform procedure which involves removal of foreign body at the same time.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73819829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial Disease Masquerading as Recurrent Encephalopathy","authors":"Rajalaxmi Satapathy, Pragateshnu Das","doi":"10.1055/s-0043-1761616","DOIUrl":"https://doi.org/10.1055/s-0043-1761616","url":null,"abstract":"Abstract A young male who was a diabetic presented with gradually progressive hearing loss, recurrent episodic behavioral abnormality, easy fatigability, proximal weakness, and seizures. The patient was evaluated in detail to find out the etiology of encephalitis. The serum autoimmune encephalitis panel was negative. On magnetic resonance imaging of the Brain, there was temporoparietal T2 and fluid-attenuated inversion recovery hyperintensity. In the magnetic resonance spectroscopy study, a lactate peak was found. So, the patient was evaluated for mitochondrial illness mitochondrial encephalopathy lactic acidosis with stroke-like symptoms) and it was confirmed by a genetic study. This case illustrates that though it is a rare disease, always a strong clinical index of suspicion is required for the diagnosis of mitochondrial disorders in case of multisystem involvement so that diagnosis would not be missed.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86876482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Clinicoradiological Score – Valuable Tool to Assess the Risk of Strangulated Small Bowel Obstruction in Tertiary Care Center”","authors":"Gunasekaran Monisha, M. S, H. Ranganath","doi":"10.1055/s-0043-1761416","DOIUrl":"https://doi.org/10.1055/s-0043-1761416","url":null,"abstract":"Abstract Background  Small bowel obstruction accounts for about 3% of the emergency laparotomies, hence there is a need for early recognition of the risk associated with strangulated small bowel obstruction. However, there is no single reliable tool for evaluating the bowel strangulation risk precisely and quickly, hence we sought to assess the specificity and sensitivity of a scoring system named “Clinicoradiological score” as a tool to assess the risk of strangulated small bowel obstruction in tertiary care center for early intervention. Methods  The study was an observational study conducted on 50 patients with clinical symptoms of small intestinal obstruction, diagnosed by CT and admitted in-patient basis at the general surgery department in the hospitals attached to Bangalore Medical College and Research Institute, Bengaluru from November 2017 to May 2019. In this scoring system, one point was given to each factor which includes pain duration (4 or more days), guarding, leucocyte count at least 10 ×10 9 /L, C-reactive protein 75 mg/L or more, free fluid at least 500 mL (CT criteria), reduced wall contrast enhancement (CT criteria) leading to a maximum score of 6. Statistics  Based on standard treatment outcome, patients were grouped into three categories (conservative management, laparotomy without resection and anastomosis, and laparotomy with resection and anastomosis). Data was analyzed by descriptive statistics. The risk factors were compared between three patient groups and Chi-square test used for hypothesis testing. Sensitivity and specificity were evaluated for accuracy of score. Results  Out of the six factors of Clinicoradiological score, five factors were found to be predictors ( p -value <0.01), while history of pain more than 3 days did not have a significant p -value. In our study all 18 patients with score more than 3 had gangrenous changes and underwent resection. The p -value of the score was found to be significant. Conclusion  Clinicoradiological score has been proved to be a valuable tool in predicting the risk of strangulated small bowel obstruction and ascertained the need for subsequent intestinal resection.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86989678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knotted Stent—Emphasizing the Need of Radiology Assistance in Urology","authors":"S. P. Dhangar","doi":"10.1055/s-0043-1764364","DOIUrl":"https://doi.org/10.1055/s-0043-1764364","url":null,"abstract":"Abstract Ureteral double-J stents have become a part and parcel in contemporary urologic practice. As the use of stents is increasing, the complications are also increasing. Knot formation in the double-J stent is rare phenomenon. Twenty-seven cases have been reported till now. This case would be the 28th case to be reported, in a young male with solitary left kidney and who was on regular periodic stent substitution.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73797671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Radiological Results of Minimally Invasive Two-Hole Dynamic Hip Screw Fixation of Stable Intertrochanteric Fractures: A Prospective Study of 50 Patients","authors":"F. A. Dar, Zaffar Iqbal, A. H. Lone, N. Ali","doi":"10.1055/s-0043-1761618","DOIUrl":"https://doi.org/10.1055/s-0043-1761618","url":null,"abstract":"Abstract Background  Intertrochanteric fractures are fractures of elderly population and are known for morbidity and mortality. Early stabilization with minimal surgical trauma is important for early mobilization to prevent recumbence-related complications. Methods  This prospective study was conducted on 50 stable intertrochanteric fractures that were managed by fixation with a small two-hole dynamic hip screw –(DHS) side plate using a minimally invasive technique. The surgical time, intraoperative blood loss, length of the skin incision, duration of hospital stay, time to full weight bearing and fracture union, and complications were recorded. Results  The mean age of the patients was 60.2 years with 64% belonging to male sex. The mean operative time, average blood loss, and mean incision length were 35.6 minutes, 68.4 mL, and 3.7 cm, respectively. Time to bone healing ranged from 10 to 16 weeks (mean 13 weeks). Two patients had hip screw backout but that did not interfere with failure of fixation. Conclusion  Stabilization of stable intertrochanteric fractures with two-hole DHS using minimally invasive approach is a viable option with negligible complication rate related to failure of small DHS side plate.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83775477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Primary EAC Cholesteatoma Extending into Antrum with Normal Middle Ear","authors":"S. Shrivastava, Rishita Kalra, Somyagupta Somyagupta, V. Pathak, P. Nayak, Stuti Shukla","doi":"10.1055/s-0043-1761458","DOIUrl":"https://doi.org/10.1055/s-0043-1761458","url":null,"abstract":"Abstract Introduction  A cholesteatoma is a three-dimensional sac lined by keratinized squamous epithelium containing desquamated keratinized epithelial cell which secretes enzymes that have the tendency to expand and erode the bony structure underlying it and cause intracranial and extracranial complications. This cystic mass is in an abnormal location such as the middle ear, the petrous apex, or the external auditory canal (EAC). It is mostly found in the middle ear and rarely in the EAC. Here we have reported a rare case of unilateral primary EAC cholesteatoma with mild hearing loss in a middle-aged male. Case Report  We have reported a case of a 34-year-old male with complaints of right-sided ear discharge and right-sided decreased hearing for the last 5 to 6 years. On examination, right ear EAC was found to be dry, and a sac was observed in posterior wall extending to mastoid present with clear attic, and intact retracted tympanic membrane that was then followed by radiological evaluation to establish the diagnosis of EAC cholesteatoma. This was surgically treated and ear was cleared of all disease. Patient's symptoms improved postoperatively. Conclusion  Primary EAC cholesteatoma with disease-free middle ear is a rare finding and there is very less definitive literature available on the pathogenesis of the same.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82976986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atraumatic Isolated Bilateral Fibular Shaft Fragility Fracture: A Rare Case","authors":"Suryakanth Kalluraya, AA Hosangadi, Prabhu P. Munavalli, Akash Kumar","doi":"10.1055/s-0043-1764363","DOIUrl":"https://doi.org/10.1055/s-0043-1764363","url":null,"abstract":"Abstract Fragility fractures, a form of stress fracture brought on by physiological stress on weak bones, are not common. It might be challenging to diagnose a fragility fracture since a standard radiograph shows signs of fracture repair rather than the actual fracture. We present a case of a 32-year-old woman who has been complaining of both leg pain for the last 4 months and has been unable to stand for the last 1 week. Further analysis revealed that her vitamin D levels were insufficient.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76773623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Treatment Outcome of Blast Injuries to the Hand at a Tertiary Hospital of Kashmir Valley, India","authors":"Junaid Khurshid, S. A. Bashir, A. Rasool, Onkar Kulkarni","doi":"10.1055/s-0043-1762569","DOIUrl":"https://doi.org/10.1055/s-0043-1762569","url":null,"abstract":"Abstract Background:  Blast injuries to hand can have disastrous consequences on account of loss of critical hand functions. This study was conducted to study the epidemiology and outcome of hand blast injuries reporting to emergency department of a tertiary care hospital. Materials and Methods:  All the blast injuries to hand admitted at our center between 2016 and 2020 were assessed at the time of injury and at 6 weeks after completion of primary management. The severity of injury and functional outcome was assessed using modified hand injury severity score (HISS) and quick disabilities of the arm, shoulder and hand (QuickDASH) scale, respectively. Descriptive statistics was calculated and correlation between HISS and DASH was assessed using Pearson's correlation coefficient. Results:  A total of 26 cases with a mean age of 23.12 ± 9.1 years were included. The subjects included 25 males and 22 subjects had injury to their dominant hand. The grade of injury was severe in 12 (46.15%) cases followed by moderate in 5 (19.2%) cases and major in 5 (19.2%) cases. The mean HISS score at injury was 67.46 ± 37.6. The mean QuickDASH score at follow-up was 37.24 ± 29.7. QuickDASH score at follow-up had a significant correlation with HISS score at baseline with a Pearson's correlation coefficient of ( r  = 0.67, p  = 0.0012) Conclusions:  Blast injuries to hands are primarily seen in young males with low-grade explosives being the primary source of injury. Dominant hand is most commonly involved with many cases needing revascularization procedures. Higher severity of blast injuries to hand is associated with poor outcome at follow-up.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90853823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Prescription Pattern in ENT Outpatient Department in a Tertiary Care Teaching Hospital, Telangana, India","authors":"Naveen Aalasyam, Shilpa Potnuru, Chandra Mouli Sileveru, Uma Pokala, N. P.","doi":"10.1055/s-0043-1761502","DOIUrl":"https://doi.org/10.1055/s-0043-1761502","url":null,"abstract":"Abstract Introduction  Otorhinolaryngological infections are very common in adults and in children also. These infections are caused by various microorganisms and to treat these infections, antimicrobial agents are used frequently. As irrational use of antimicrobials leads to the development of antibiotic resistance and it is a big threat to the society, the present study was planned to get awareness among the practitioners regarding the antimicrobial prescription pattern. Aim  To study the prescription pattern of antimicrobial agents in outpatient department of otorhinolaryngology in a tertiary care teaching hospital. Materials and Methods  An observational study was planned over a period of 8 months from July 2019 to February 2020 in ENT outpatient department (OPD) at Mamata General Hospital, Khammam in Telangana. In total, 562 prescriptions were collected. Patient's details, probable diagnosis, prescribed medication details such as generic name, dose, and dosage forms were taken. The collected data was analyzed and the conclusions were drawn using descriptive analysis. Results  Total number of prescriptions were 562. The majority of the prescriptions belonged to the 21 to 40 years of age group. Males were included more than females (males 320 and females 242). Chronic suppurative otitis media (CSOM) (16.2%) was the commonest infection. Most commonly prescribed antimicrobial was amoxicillin and clavulanic acid combination (26.17%), followed by cefpodoxime with clavulanic acid (21.9%) and ciprofloxacin (19.06%). In 371 (66.01%) prescriptions, only one antimicrobial was prescribed, whereas in 36 (6.40%) prescriptions no antibiotic was given. The average number of drugs per prescription was 3.18 and the average number of antimicrobials per prescription was 1.25. Tablet form (52.9%) was the commonest dosage form and most of the drugs were prescribed by generic name (74.06%). Conclusion  The present study though prescription pattern of antibiotics and adherence to the hospital formulary by the physicians in the hospital is encouraging, still there is a chance in reducing the number of drugs prescribed per patient. The findings of this study will be useful to prescribe antimicrobials rationally so that the patient and health care system on the whole will be benefited.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85245556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}