Karnataka Medical Journal最新文献

{"title":"Comparison of the systolic blood pressure and limb occlusion pressure methods in determining effective tourniquet pressure in upper limb surgeries","authors":"Chineme Martin Akah, O. Lasebikan, J. Asuquo, Uche A. Katchy, U. Anyaehie, Samuel Chukwudi Uzodimma, K. Madu, B. Asuquo","doi":"10.25259/kmj_20_2024","DOIUrl":"https://doi.org/10.25259/kmj_20_2024","url":null,"abstract":"\u0000\u0000The importance of a tourniquet to a surgeon cannot be over emphasised. Pneumatic tourniquet pressure is usually determined by systolic blood pressure (SBP), but a new emerging method, the limb occlusion pressure (LOP) appears more promising, especially in upper limb surgeries. We compare the effectiveness of the SBP and LOP methods in determining the tourniquet pressure in forearm bone surgeries.\u0000\u0000\u0000\u0000This study was a prospective comparative study involving 60 forearm bone surgeries conducted over a 1-year period with randomisation into two groups. Those whose tourniquet pressure was determined using the SBP method (Group A) and those whose pressure was determined using the LOP method (Group B). Data collected included the tourniquet pressure, tourniquet performance using a Likert scale as well as tourniquet-related complications were noted. Analysis was done with the Statistical Package for the Social Sciences (version 22 trademark of the International Business Machine) and Excel (version 13.0, Microsoft, Redmond, WA).\u0000\u0000\u0000\u0000There was a statistically significant difference in the mean tourniquet pressure between the two groups (SBP = 234.43 ± 11.87 mmHg; LOP = 199.17 ± 16.44 mmHg, P < 0.001). Both methods provided a satisfactory dry field throughout the tourniquet duration with no statistically significance difference in the tourniquet performance between the two groups. Although two cases of tourniquet-related nerve palsy were noted in the SBP group, it was not statistically significant (P = 0.355).\u0000\u0000\u0000\u0000The LOP method provided a satisfactory dry surgical field at a lower tourniquet pressure than the SBP method with no complications.\u0000","PeriodicalId":513551,"journal":{"name":"Karnataka Medical Journal","volume":"43 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819294","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 comparative study of proximal femoral nail and dynamic hip screw for intertrochanteric fractures of the femur","authors":"Aabid Husain Ansari, Asif Hussain Ansari","doi":"10.25259/kmj_13_2024","DOIUrl":"https://doi.org/10.25259/kmj_13_2024","url":null,"abstract":"\u0000\u0000Intertrochanteric fracture is one of the most common fractures of the hip. However, the implant of choice for type II intertrochanteric fracture is still under debate. The aim of this study was to compare the functional outcomes of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of intertrochanteric fractures.\u0000\u0000\u0000\u0000We did a prospective comparative study on 60 patients of type II intertrochanteric fractures operated with closed/open reduction and internal fixation with either DHS or PFN between October 2018 and March 2023. During each follow-up, the functional outcome of patients was calculated using the Harris hip score.\u0000\u0000\u0000\u0000There was a statistically significant difference present in average functional scores between the two groups at 1 month, 3 months and 6 months; however, no difference was seen at the end of 12th month follow-up. Functional outcomes in the DHS group were excellent in 34.78%, fair in 17.39%, good in 43.48% and poor in 4.35%. In the PFN group, results were excellent in 56.52%, fair in 8.70% and good in 34.78% and no poor results were seen.\u0000\u0000\u0000\u0000In stable two-part intertrochanteric femur fractures, both PFN and DHS are equally effective but due to minimal invasiveness. PFN is a better implant of choice than DHS in the treatment of elderly patients with intertrochanteric fractures.\u0000","PeriodicalId":513551,"journal":{"name":"Karnataka Medical Journal","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648413","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":"Rare case of assault with knife penetrating base of the skull – Retrieval and management","authors":"M. Vijapur, Kumar Saket, Kajal Kumari, Vasanth Kattimani","doi":"10.25259/kmj_8_2024","DOIUrl":"https://doi.org/10.25259/kmj_8_2024","url":null,"abstract":"Addressing a penetrating injury in the maxillofacial region poses significant challenges for oral and maxilofacial surgeons due to the presence or critical structures. Damage to these structures can lead to varying degrees of impairment and a decreased quality of life for the patient. A 48-year-old individual sustained a stabbing injury to the left side of their face. The knife remained lodged inside for 7 h until they were admitted to the trauma unit. The assailant had unsuccessfully attempted to remove the weapon by bending its handle. Following thorough examinations to pinpoint the exact location of the knife, it was safely removed under sedation. The patient experienced successful healing without major complications. The minimisation of scar tissue was achieved through proper debridement and layered linear wound closure. Subsequently, the patient was transferred to the general ward for monitoring and prescribed antibiotics to prevent wound infection. This report includes a detailed account of the weapon retrieval process and is management, along with a review of relevant literature Reconstruction of complicated facial wounds is difficult for surgeons, and early treatment is necessary to avoid additional harm.","PeriodicalId":513551,"journal":{"name":"Karnataka Medical Journal","volume":"43 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350602","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":"Genetic inheritance in tandem: Non-syndromic autosomal recessive congenital ichthyosis with beta-thalassaemia: A rare coincidence","authors":"Arnab Ghorui, Gurleen Kaur, Chandra Mohan Kumar","doi":"10.25259/kmj_12_2023","DOIUrl":"https://doi.org/10.25259/kmj_12_2023","url":null,"abstract":"Ichthyosis belongs to the group of Mendelian disorders of cornification. Congenital ichthyosis is inherited as an autosomal recessive trait, so it is also known as autosomal recessive congenital ichthyosis (ARCI). ARCI is classified into two types: syndromic and non-syndromic ARCI. Non-syndromic ARCIs include lamellar ichthyosis, congenital ichthyosiform erythroderma and Harlequin ichthyosis. Syndromic-ARCI is associated with multisystemic involvement, which includes Netherton syndrome, Chanarin-Dorfman disease and others. Other systemic diseases associated with ichthyosis include Gaucher disease type II and hypothyroidism. Chanarin-Dorfman and Gaucher disease-II are additionally associated with hepatosplenomegaly (HSM) and anaemia. We describe a child of congenital ichthyosis with HSM and anaemia thought to be syndromic-ARCI, but diagnosed for beta-thalassaemia (b-thal) concurrently. An infant presented with peeling skin along with absent sweating since birth and recent onset paleness of the body. Examination revealed Ichthyosis (Lamellar-variant), severe pallor and HSM, raising the possibility of Chanarin-Dorfman syndrome and Gaucher’s disease. The investigation revealed an Erlenmeyer flask deformity of the knee, but no Gaucher’s cells were found in the bone marrow. In the absence of lipid vacuoles leaden leukocytes (Jordan’s anomaly), Chanarin-Dorfman disease was also ruled out. Haemoglobin (Hb) high-performance liquid chromatography revealed β-thal major, and both parents were traits, giving us the diagnosis, which was further confirmed by the next-generation gene sequencing for clinical exomes. This report was to highlight non-syndromic ARCI involving the CYP4F22 gene variant, which is a rare finding, and the association of such ichthyosis with β-thal major was an unexpected result. Genetic counselling was provided to the parents in light of the autosomal recessive nature of both diseases. Genes of congenital ichthyosis and β-thal were unrelated, but simultaneous expressions of two autosomal-recessive diseases together are it merely by chance or a new entity.","PeriodicalId":513551,"journal":{"name":"Karnataka Medical Journal","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140214980","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 Peutz-Jeghers syndrome presenting as multiple intussusception of small bowel – A rare surgical emergency","authors":"N. M. Srinivas, Mohammed Muzamil Pasha, Hanim Mohammed Ridwan","doi":"10.25259/kmj_9_2023","DOIUrl":"https://doi.org/10.25259/kmj_9_2023","url":null,"abstract":"Peutz-Jeghers syndrome (PJS) is an autosomal dominant genetic disorder characterised by melanin pigment spots on the oral mucosa, lips, nasal alae, palm and soles, as well as hamartomatous polyps in the alimentary canal. Polyps are often a cause of intussusception in the affected patients. Cancers of the gastrointestinal system, uterus, and breast are common in patients with PJS. Long-term follow-up is required to prevent intussusception in children and cancer in adults. We report a classical case of PJS presenting with multiple intussusception of the small bowel in a 20-year-old male patient.","PeriodicalId":513551,"journal":{"name":"Karnataka Medical Journal","volume":" 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140216515","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":"Nevus lipomatosus cutaneous superficialis - An odd site","authors":"Aravind Prasanna, Yogindher Singh","doi":"10.25259/kmj_1_2024","DOIUrl":"https://doi.org/10.25259/kmj_1_2024","url":null,"abstract":"","PeriodicalId":513551,"journal":{"name":"Karnataka Medical Journal","volume":" 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140213775","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}