Type II myocardial infarction and latent LVOT obstruction due to Systolic Anterior Motion of mitral valve
Published on: 2nd August, 2019
OCLC Number/Unique Identifier: 8198772128
Left ventricular outflow tract obstruction is a well-recognized feature in hypertrophic cardiomyopathy but can occur in other clinical scenarios when anatomically susceptible heart is subjected to permissive physiological conditions that provoke systolic anterior motion of the mitral valve (SAM): ie, reduced preload, increased inotropic state, and decreased afterload.
This report describes a case of hemodynamically significant latent LVOTO that was associated with hypotension, syncope, acute myocardial ischemic ECG changes, and an increase in cardiac enzymes. (Type II myocardial infarction) in a non HCM patient with excessive anterior mitral valve tissue.
Anasarca in a 35 year old man- A diagnostic dilemma
Published on: 17th July, 2019
OCLC Number/Unique Identifier: 8198742700
Anasarca is generalized swelling of the body following accumulation of fluid in the extracellular compartments. It may result from multiple aetiology mainly of renal, hepatic or cardiovascular origin.
The aim of this case report is to highlight the challenges encountered in making diagnosis in a patient with anarsaca.
We report a case of a 34 year old transporter who presented with anasarca. He had clinical features and risk factors suggestive of renal, hepatic and cardiovascular disease. However investigations ruled out renal, hepatic or cardiovascular diseases as the aetiology of the anarsaca. The anarsarca was also noted to be unresponsive to diuretics. The diagnosis of the disease causing the anarsaca was therefore a dilemma.
Laparoscopic approach for acute right iliac fossa pathology: Our experience
Published on: 31st December, 2020
OCLC Number/Unique Identifier: 8882678494
Laparoscopic approach in emergency theatre is an irreplaceable tool to manage patients with acute surgical pathology. We retrospectively reviewed surgical access records from the Emergency Department for acute right iliac fossa pathology. We considered 51 patients (16 male, 35 female, mean age 23.8 years) access for acute right iliac fossa pathology over the last year. 44 patients underwent laparoscopic approach (86%); 8 patients were treated with an open approach. Outcomes evaluation was based on data comparison from open appendicectomy over 4 year time period.
Variables considered for data analyses were: role of laparoscopic surgery for gangrenous/perforated appendicitis, Conversion rate, Laparoscopy appendicectomy for elderly patients.
Our study demonstrated that a laparoscopic approach at acute right iliac fossa pathology is feasible, safe and can offer a low incidence of infectious complications, less post-operative pain, rapid recovery, and represent a valid diagnostic tool in doubtful cases, at the expense of longer operating time than OA. We suggest that LA should be the initial choice for all patients with acute right iliac fossa pathology.
Brachial pseudoaneurysm associated with median nerve injury as a complication of peripherally inserted central catheter: A case report
Published on: 4th June, 2019
OCLC Number/Unique Identifier: 8165398303
Introduction: Peripherally inserted central venous catheters (PICCs) have been increasingly used as an alternative to conventional central venous catheters for long-term administration of chemotherapy, antibiotics, parenteral nutrition, and hydration in patients with difficult venous access. Traumatic complications to arteries and nerves adjacent to veins selected for PICC placement have been rarely described.
Case presentation: We report the case of a PICC placement in the brachial vein of the right upper limb of a 78-year-old woman that resulted in brachial artery pseudoaneurysm and median nerve lesion.
Discussion: The pseudoaneurysm was successfully repaired with thrombin injection, but neurological deficits to the hand resulting from nerve injury persisted even four months after the procedure.
Acute abdomen as complication of a knee arthroscopy: A case report
Published on: 22nd December, 2020
OCLC Number/Unique Identifier: 8872656452
A knee arthroscopy in spinal anaesthesia was performed on a 67 years old male patient. During the procedure the patient was hemodynamically stable, until he suddenly turned pale and started complaining of severe pain in lower abdomen with signs of guarding. The procedure was finished as urgently as possible and after releasing the tourniquet we noticed significant difference in volume of the leg, with redness distal to tourniquet. Urgent lab results were essentially unremarkable and the patient was sent for the urgent radiological diagnostics.
CD of the left leg described fluid in the soft tissues of the thigh, scrotum, and abdomen; and the unenhanced CT of the abdomen showed free fluid along the entire femoral shaft of the left thigh, extending towards pelvis and abdomen to perihepatic and perisplenic space, and retroperitoneum, with gas bubbles tracking along anterior aspect of the left thigh into the left retroperitoneum.
He was admitted to the ICU, and within few hours all symptoms have resolved and his further recovery was without complications.
Local recurrence after enlarged total nephrectomy
Published on: 5th April, 2019
OCLC Number/Unique Identifier: 8056337130
Local isolated recurrence of kidney cancer in the renal lodge after radical nephrectomy is rare and has a poor prognosis. Surgical excision, sometimes even extended to neighboring organs, is currently the only effective treatment for local recurrence of kidney cancer. The interest of new medical therapies remains to be defined. We report a case of local recurrence in a patient with radical nephrectomy.
Intentıonal reımplantatıon of hopeless teeth: Cases serıes
Published on: 31st October, 2020
OCLC Number/Unique Identifier: 8872657975
Intentional replantation is an alternative for the treatment of advanced periodontal destruction of the anterior teeth. Systemically healthy three female patient was referred to our clinic with functional complaints. Diagnosis were chronic periodontitis and class III mobility was noted at the mandibular incisors with complete periodontal attachment loss. After phase I periodontal treatment periodontally involved teeth were extracted, endodontic treatment accomplished, the teeth were replanted and fixed to its place with fiber reinforced composite splint. At the end of 2 years tooth was in function with alveolar bone gain. Intentional replantation provided long-term maintenance of patient’s own teeth.
A Case of Acute Peripheral Vertigo: Using the HINTS Exam to guide diagnostic workup
Published on: 8th March, 2019
OCLC Number/Unique Identifier: 8056258799
Acute dizziness/vertigo is among the most common causes for visiting the emergency department or primary care physician. Although the majority of these presentations represent an acute peripheral vestibulopathy (APV), lateral medullary, lateral pontine, and inferior cerebellar infarctions can mimic APV very closely. We present an atypical presentation of an aggressive APV and outline how a well-constructed bedside neurotologic evaluation can distinguish central from peripheral vertigo in the acute setting.
The role of robotic segmentectomy for non-small cell lung cancer
Published on: 6th October, 2020
OCLC Number/Unique Identifier: 8682303248
Segmentectomy may be applied to all segments; superior segmentectomies (lower lobe superior segments for both lungs), lingulectomies (two segments forming lingulas of upper left lobe) and basal segmentectomies (segments other than superior segment for both lungs). In lung segment resections; segmentectomy has an equivalent morbidity, recurrence and survival rate compared to lobectomy, in patients with stage I lung cancer, tumors smaller than 2 cm and within the segmental anatomical limits. Segmentectomy also contributes more to preserving lung function and exercise capacity than lobectomy. In tumor resection; especially in patients with advanced age, insufficient performance or insufficient cardiopulmonary reserve, 2 cm in diameter and acceptable segmental margins may be provided.
Limited long-term results show oncological results of robotic approach similar to open and VATS approaches. Robotic approach facilitates surgery with more intuitive movements, greater flexibility and high definition, three-dimensional vision. However, high cost and lack of touch sense are main disadvantages of robotic surgery. New studies are needed to assess quality of life, morbidity, oncological results and cost effectiveness. However, considering development of technology in our age and fact that many surgical robot brands will be released in the near future, it is predicted that disadvantages of robotic surgery will be minimized in the near future.
This article reviews experience of segmentectomy in non-small cell lung cancer and discusses benefits and limitations of robotic segmentectomy.
Video-assisted thoracic surgery in advanced non-small cell lung cancer treatment
Published on: 14th August, 2020
OCLC Number/Unique Identifier: 8653118841
Non-small cell lung cancer is one of the leading causes of cancer-related mortality worldwide. Despite recent advances in adjuvant treatments, surgical resection is basis of treatment. With the development of minimally invasive surgery in thoracic surgery, surgeons work on minimally invasive surgery for advanced stages of lung cancer, previously considered non-operable at all or previously considered non-operable with minimally invasive surgery approach.
Minimally invasive surgical techniques which are routinely used in the surgical treatment of early-stage lung cancer have started to be treated in more complicated and advanced stages of lung cancer. Bilateral anatomic resections, operations after neoadjuvant chemotherapy, bronchial sleeve lobectomies, double sleeve lobectomies, complementary pneumonectomies, and carinal sleeve resections can be performed by minimally invasive methods. The option of video-assisted surgery should be considered with oncological principles at foreground if patients have acceptable lung and cardiac performance conditions with minimal comorbidities.
This study reviews VATS experience in patients with advanced-stage lung cancer worldwide and discusses potential benefits and limitations of using VATS technology to perform thoracic surgery procedures.
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