surgery

Physiotherapy treatments employ complex approaches tailored to the patient’s diagnosis. Exercise is the primary strategy to enhance rehabilitation processes for most individuals. However, electrophysical agents, such as Photobiomodulation (PBM), that utilize specific wavelengths of light to penetrate tissues and stimulate cellular activity, can modulate various biological processes and may improve physiotherapy outcomes. This non-invasive treatment can reduce pain and inflammation, promote tissue repair, and accelerate tissue healing. Currently, PBM has numerous applications, including pain and inflammation treatment, wound healing (such as diabetic foot ulcers, pressure ulcers, post-surgery wounds, and skin grafts in burn injuries), and the management of musculoskeletal disorders (such as arthritis, tendinopathies, muscle injuries, and spinal disorders). It is also utilized to improve muscle performance and recovery in rehabilitation and sports. Additionally, transcranial PBM has shown promise in enhancing neurorehabilitative processes by facilitating the recovery of cognitive and motor functions in various types of lesions. The safety and efficacy of this treatment allow it to be incorporated alongside regular exercises and manual therapies as an adjunctive treatment, potentially enhancing outcomes in different areas of rehabilitation.

Verrucous hyperplasia is a wart-like lesion that can develop on amputation stumps, often due to poor-fitting prostheses, venous stasis, friction, and bacterial infections. While surgical excision is sometimes necessary for intractable cases, many instances can be managed non-surgically. We present the case of a 35-year-old male with a slowly growing verrucous plaque on his amputated stump that had caused repeated infections. His prosthesis was loose, allowing the stump to hang loosely inside the socket. After histological confirmation of verrucous hyperplasia, he was advised to change his prosthesis and use compression bandaging. Over 5 months, the lesion resolved without surgery. Early recognition and non-surgical management, including proper prosthetic fit, compression, and hygiene, can often successfully treat verrucous hyperplasia of amputation stumps. This avoids the need for excision in many cases. Patients and clinicians should be aware of this condition and the importance of prosthetic fit and limb care to prevent and treat it.

Ventricular Septal Defect, also known as VSD is a rare and life-threatening complication associated with MI. Therefore, it should be immediately diagnosed and treated. Transcatheter closure of the ventricular septal defect is a new alternative treatment approach compared to surgery. In this case, we presented a patient with post-infarct basal ventricular septal defect whose ventricular septal defect was closed using an atrial septal defect closure device. The ability to successfully close such a large defect via catheter is promising for the treatment of patients with VSD.

Background and importance: Sacral fractures often lead to injuries of the lumbosacral nerve, which will cause tremendous damage to the patient’s motor and sensory functions. At present, the most commonly used surgical method is the posterior median approach, the extent and degree of neurolysis are often insufficient, so the effect of neurolysis is not well, and the functional recovery of patients after operation is often incomplete.Clinical presentation: The patient was a 17-year-old male who accidentally fell from a height and landed on his hip. The main clinical feature of the patient was persistent radiating pain in the right lower extremity with right lower limb sensorimotor disorder. The results of the X-ray examination indicated a sacral fracture and a right pubic fracture. After the injury, the patient underwent pelvic internal fixation surgery within 72 hours. Then 6 months after the surgery, there was no significant improvement in right lower limb function, and the patient came to our hospital seeking treatment. Considering the severe lumbosacral plexus injury and the history of surgery, we performed an “Anterior surgery approach combined with posterior approach for lumbosacral neurolysis” for the patient, postoperative radiation pain disappeared completely, and there were significant improvements in the muscle strength of some muscles and sensory function.Conclusion: The relaxation of the lumbosacral plexus is usually performed through a single surgical approach, which has great limitations in the effect of relaxation. Here, we demonstrate a case in which posterior lumbar incision and anterior laparoscopic lumbosacral plexus neurolysis can benefit the patient, the lumbosacral nerve was released to a great extent. We aim to bring this case to the attention of our worldwide neurosurgical colleagues and share our surgical approach to assist those who may encounter this case in the future.

Context: Several texts and literature suggest that corpus callosum may be sexually dimorphic. Previous researchers found that the length of the corpus callosum is larger in males than in females. Reviewing various foreign literature found that the length of the corpus callosum may change in many diseases in Neurology, Neurosurgery, and Psychiatry. So, knowledge of the normal morphological difference of the length of corpus callosum between Bangladeshi males and females is essential for the diagnosis in brain imaging and treatment of those diseases. Objective: The present study was conducted to provide data on the length of the corpus callosum of our people, which can be used to set a standard measurement for the Bangladeshi population. Materials and methods: A cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, Bangladesh, from July 2009 to June 2010, based on the collection of 60 human brains (male 36 and female 24) from unclaimed dead bodies. The lengths were measured by using digital slide calipers in mm.Results: The mean length of the corpus callosum in males and females in groups A, B, C & D (grouping in done on age difference) were 68.04 ± 0.99 and 67.03 ± 0.05 mm, 67.50 ± 0.13 and 67.02 ± 0.03 mm and 67.51 ± 0.03 and 67.02 ± 0.03 mm respectively.Conclusion: Statistically significant differences were found between males and females in all age groups in the length of the corpus callosum.

A details development in recent dermal studies being carried out and purposed dermal studies is investigated in this research review globally and the various disease and process functions and treatment with symptoms and etiology and pathophysiology of skin-related issues are studies and practically feasible solution of various integumentary systems related problem and it’s function is researched and almost 30 types of common skin related diseases and remedies studies by researcher and it’s company KIRDPL in global perspectives and especially in tropical climate zone in various cases in patients is mentioned including plastic surgery to gene therapy and dermabrasion to the genetic disease as well. The integumentary systems in the animal kingdom as a whole are focused and homosapiens' human dermal functions and their development and future developments of stem cells laboratory-grown skin coats of different colors for shedding and treatments of cancerous skin and integumentary system and gene therapy of the ailments are discussed.

Anaplastic Pleomorphic Xanthoastrocytoma is a very rare tumor of the Central Nervous System (CNS). BRAFV600E mutation is a common mutation in pleomorphic xanthoastrocytoma. We present a 52-year-old male patient who underwent total resection due to a temporal lobe mass. The primary tumor in the temporal lobe was given postoperative radiotherapy. During follow-up, genetically and histologically proven metastasis was detected in the paraspinal region. The adjuvant RT was given to metastasis after surgery. The patient, who used the combination of dabrafenib and trametinib after recurrence, is being monitored in remission.

Cystoid Macular Oedema (CMO) is a condition characterized by fluid accumulation in the macular region of the retina, leading to the formation of cyst-like spaces. This edema often results in visual impairment and is associated with various ocular and systemic conditions, including surgery, inflammation, or medication use. The authors present a case where Cystoid Macular Oedema (CMO) occurred after commencing topical bimatoprost in a pseudophakic patient with primary open angle glaucoma. The macular oedema was treated effectively with a combination of non-steroidal and steroidal topical drops. This case report shows a possible correlation between bimatoprost and CMO, in a patient with no recent confounding risk factors known to contribute to CMO . The recommendation from this report is that all patients treated with topical bimatoprost drops should have a baseline macula OCT examination and a repeated OCT examination 8 weeks after initiation of treatment, to facilitate early detection of CMO.

Endoscopic dacryocystorhinostomy (EDCR) is a well accepted surgical treatment for patients with nasolacrimal duct obstruction (NLDO). Previously, external dacryocystorhino-stomy was considered as the gold standard treatment for NLDO, however, EDCR has gained momentum due to its several advantages. The EDCR has been sounding more aesthetic and as functional compared to the traditional external dacryocystorhinostomy in the surgical treatment of nasolacrimal duct obstruction with comparable outcomes. Purpose: to determine the success rate and complications of endoscopic dacryocystorhinostomy without stenting.Materials and methods: it was a retrospective study performed in the department of Otorhinolaryngology and Head and Neck Surgery (ORL-HNS), Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from June 2019 to September 2024. A total of 19 patients charts were reviewed. All the cases were performed under general anesthesia. All the cases had undergone without silicon stenting and were regularly followed up for a period of 3 months. Post operative stomal patency and complications were noted based on subjective and endoscopic evaluation.Results: Out of 19 patients, 12 were female and 7 were male with the age range of 12 to 70 years. Transnasal synechiae was seen in 2 female and 1 male patients. Stomal patency was 100% with no recurrence of epiphora in 17 patients (89.4%) during 3 months of follow up. 2 female patients with released synechiae didn’t come for 3 months follow up.Conclusion: It is a safe and minimally invasive procedure and has a comparable success rate to external DCR with an additional advantage of more aesthetic value.

Scoliosis is a condition of abnormal lateral curvature of the spinal column greater than 10 degrees as measured by Cobb’s angle. The two main groups of scoliosis are idiopathic scoliosis and non-idiopathic scoliosis. The diagnosis of an idiopathic scoliosis is made if a non-idiopathic one has been excluded. Idiopathic adolescent scoliosis is a more common form. Neuromuscular scoliosis, which is a type of non-idiopathic scoliosis, is characterized by diverse muscular and neurological impairments. Anesthesia and surgery for neuromuscular scoliosis have a higher risk of perioperative complications than for idiopathic cases.

Background: Methemoglobinemia is an uncommon hematological condition in which hemoglobin contains iron in an oxidized (Fe³+) state with limited oxygen-carrying ability. It can be congenital or acquired. Anesthetic management of methemoglobinemia poses a great challenge, as there is a risk of refractory hypoxemic crisis in the perioperative period. Case: Here, we present a case of a 24-year-old female with congenital methemoglobinemia who presented with gallstone disease for laparoscopic cholecystectomy under general anesthesia. She had a deficiency of cytochrome B5 reductase, which contributed to 26% of methemoglobin levels on co-oximetry. Despite taking considerable precautions to avoid hypoxemic episodes and metabolic acidosis, an episode of desaturation happened at the end of the procedure, which was managed with intravenous methylene blue. The patient recovered without any hypoxemic insult. Conclusion: Anesthetic management of patients with moderate (20% - 30%) methemoglobinemia can be successful with extreme precautions to avoid events that can increase the methemoglobin levels and adequate preparation and availability of intravenous methylene blue.

Objectives: Hospitalization following a head injury is associated with high rates of disability that have a strong correlation with depression, anxiety, and low self-esteem. Well-being is related to life satisfaction, quality of life, happiness, personal growth and flourishing, competence, self-acceptance, positive relationships, and autonomy. The well-being of patients and their primary caregivers is important when a patient is left with impaired mobility after neurosurgery. The aim of this study is to examine whether the well-being of patients and their primary caregivers will differ before and after neurosurgery, and whether well-being differs between patients with motor disability (WMD group) and those without, compared to those who are not - NMD group (non-motor disability).Methodology: 123 patients and their main caregivers were recruited. Of these, 62 were in the before neurosurgical group, 31 Patients and 31 caregivers. 61 in the after neurosurgical group, 30 Patients and 31 caregivers, of which there are 16 from WMD group and 15 from NMD. Main outcome measures: Two analyses of Variance (ANOVA) were conducted: for WMD and NMD separately. The results reveal a significant decrease in wellbeing for both, patient and main caregivers, but a stronger decline in well-being was observed among WMD, as indicated by a larger effect size (η² = 0.74) compared to the NMD (η² = 0.38). In addition, no significant effect between group and time of measurement was found, indicating that the decrease in wellbeing was not different among patients compared to their main caregivers. Conclusion: The findings highlight the multifaceted impact of neurosurgery on well-being, particularly for patients who remain with motor disabilities and their primary caregivers.The decline in well-being after neurosurgery highlights the need for improved social support and the importance of developing treatment programs that can help ease the process of coping with these phenomena and provide appropriate support for both patients and their primary caregivers.

Introduction: Flow analysis in the apical view of transthoracic echocardiography is validated to assess fluid responsiveness at the bedside. Still, it is not always reachable, especially in mechanically ventilated patients and during surgery. We compared it to supra-sternal and sub-xiphoid views to evaluate their validity in assessing fluid responsiveness in critically ill patients.Method: A cross-sectional prospective monocentric pilot study of three months duration has been led in the critical care unit for surgical emergencies of Ibn Sina University Hospital of Rabat (Morocco). We used the time-velocity index (VTI) and peak velocity variation (∆Vpeak) values correlation between the three acoustic windows as the main judgment criteria. Measurement of data was made in the Left Ventricle Outflow Tract (LVOT) in the 5-chamber apical view, Descending Thoracic Aorta (DTA) in the supra-sternal view, and Right Ventricle Outflow Tract (RVOT) in the sub-xiphoid view.Results: There were 14 adult patients involved in the study, and the data presented are preliminary results. There was no significant difference in VTI and ∆Vpeak values between the three acoustic windows at each time of the study protocol, with a very high correlation for initial VTI value between 5-chamber apical view and supra-sternal view (r = 0.96, p < 0.001), and sub-xiphoid view (r = 0.86, p < 0.001). A very high correlation of initial ∆Vpeak value was also observed between the 5-chamber apical view and supra-sternal view (rho = 0.89, p < 0.001) and sub-xiphoid view (rho = 0.79, p < 0.001).Discussion: Supra-sternal and sub-xiphoid views showed high potential to predict fluid responsiveness, but further data are needed to validate their use for this purpose in ICU and in operating room.

Introduction: Pleomorphic Carcinoma (PC) is a subset of poorly differentiated non–small cell lung cancer that is diagnostically challenging because it is a rare malignancy of the lung. It shows varying dual-cell components; spindle or giant cells and epithelial cells.Method: We report a case of 68-year-old non-smoking female who presented with cough, fever, pain in the left side of chest & weight loss of recent onset and an abnormal shadow on her chest X-ray. Computed tomography of chest revealed a well defined heterogeneously enhancing cavitatory soft tissue lesion in the posterior basal segment of the left lower lobe with mediastinal lymphadenopathy.Results: Fine needle aspiration cytology& percutaneous lung biopsy confirmed poorly differentiated malignant tumor. Patient underwent a left lower lobectomy. A diagnosis of PC was confirmed after Immunohistochemistry (IHC). Mutation analysis revealed an EGFR exon 21 mutation within the tumor cells. The patient is on Gefitinib based chemotherapy and has remained disease-free for three years post-surgery.Conclusion: PC of the lung is a rare pathological entity. Definite diagnosis may only be made on a resected tumor along with the use of IHC. Surgical resection is the main modality of the treatment. Such rare cases should be documented to establish an optimal management plan and to provide a further insight to targeted therapy.

Pancreatic duct stones (PDS) are a common complication of chronic pancreatitis (CP). PDS can lead to duct obstruction and cause chronic abdominal pain. Ductal stone clearance, as well as short and long-term pain relief, is the cornerstone of endoscopic or surgical treatment. A step-up approach seems reasonable in pancreatic duct stone clearance. Extracorporeal shock wave lithotripsy (ESWL) combined with standard endoscopic retrograde cholangiopancreatography (ERCP) is as effective as a surgical approach for treating painful CP with less morbidity and medical costs. Therefore, endotherapy is considered a first-line therapy in selected patients. In case of insufficient pancreatic ductal clearance or strictures, advanced endoscopic techniques, per-oral pancreatoscopy (POP) with intraductal lithotripsy and/or endoscopic ultrasound-guided ductal drainage (EUS-PDD), will expand the role of the endoscopic approach. Because these new techniques are challenging, technically complex, and with high adverse events (AEs), they should be reserved for advanced tertiary care centers. Although there is increasing data that early surgical intervention may lead to better pain control and pancreatic duct stone clearance, surgery is reserved for patients failing endotherapy or patients with suspected malignancy.