Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsTopical Sevoflurane: An Alternative Treatment for Pressure Ulcers.
Pressure ulcers are a common problem in intensive care unit (ICU). Recently, topical sevoflurane has been used especially for treatment of venous ulcers and infected skin ulcers. We present a case of topical sevoflurane treatment of a pressure ulcer. ⋯ After one month, the ulcer size was decreased, necrotic tissues were cleared, and wound cultures were negative. There are three beneficial effects of local sevoflurane treatment: good analgesic action, antibiotic effects, and acceleration of wound healing. These beneficial effects may make sevoflurane an alternative treatment for pressure ulcers in an ICU.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsRecurrent, Large, Extraskeletal Osteosarcoma at the Back.
Extraskeletal osteosarcoma is a rarely identified variety of sarcomas throughout the world, which is still a dilemma for the surgeons' community with respect to its diagnosis and treatment. It is slow-growing in nature, and attains a huge size usually at presentation, which puts the clinician in jeopardy with regard to its management. Our case is the first of its variety documented in Pakistan. ⋯ We did the excisional biopsy of the mass, followed by complete removal with intact margins. Histopathology revealed extraskeletal osteosarcoma as the final diagnosis. We suggest that this tumor should be included in the differential diagnosis of all large, recurrent soft tissue masses in the body.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsSurgically-assisted Rapid Maxillary Expansion under Local Anesthesia.
Developmental, traumatic and congenital factors, among many others, may lead to transverse maxillary deficiency (TMD). TMD can be corrected by orthodontic treatment, and may also require surgical intervention. ⋯ Whether or not to separate, the pterygomaxillary junction is also one of the most common subjects of debate in this regard. In this case presentation, the transverse expansion of the maxilla was completed by means of surgically-assisted rapid maxillary expansion operation performed under local anesthesia without separating the pterygomaxillary junction and nasal septal osteotomy; and the patient, in whom orthodontic treatment had been completed, made a successful recovery without complications.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsStrangulated Intrapericardial Diaphragmatic Hernia after Hybrid Maze Procedure.
Convergent hybrid maze procedure is very safe and effective surgical modality for the treatment of refractory atrial fibrillation. It carries very little risk of complications and an intrapericardial diaphragmatic hernia is amongst the rarest of complications. ⋯ This case report describes a middle aged gentleman admitted in emergency department with life-threatening condition of small bowel obstruction secondary to strangulated intrapericardial diaphragmatic hernia. He was resuscitated in Surgical Assessment Unit and underwent emergency laparotomy involving bowel resection and repair of diaphragmatic hernia.