J Postgrad Med
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Review Case Reports
Traumatic transverse fracture of sacrum with cauda equina injury--a case report and review of literature.
Fractures of the sacrum are rare and generally associated with fracture of the pelvis. Transverse fractures of the sacrum are even less frequent and neurological deficit may accompany these fractures. A case of transverse fracture sacrum with cauda equina injury treated by sacral laminectomy and root decompression, is reported.
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A young girl with nitrobenzene induced methaemoglobinaemia was saved by the timely use of mechanical ventilator, administration of oral methylene blue and parenteral ascorbic acid. Though parenteral methylene blue is the antidote of choice, due to its non-availability, the laboratory preparation of methylene blue have been utilized orally. The rare occurrence of such cases, and the efficacy of oral methylene blue and other supportive measures in evading death due to Nitrobenzene poisoning have been highlighted.
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Review Case Reports
Duplication cyst of the pylorus--a rare cause of gastric outlet obstruction in the newborn.
Duplication cysts of the pylorus are the rarest of alimentary tract duplications with very few reported cases. We present such a cyst in a neonate presenting with gastric outlet obstruction. ⋯ Even though several modes of surgery have been described, it is best to individualize the surgical option in each case. The results depend on the nature and site of duplication, complications and the associated anomalies.
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Gap non-union of tibia following traumatic bone loss or infection dramatically emphasizes the limitation of conventional reconstructive techniques. With presence of significant skin loss or poorly vascularised recepient bed, complications and failure rate increase and solution often lies in amputation. Vascularised ipsilateral fibular grafting offers a viable alternative to this. ⋯ All the cases were secondary to osteomyelitis following compound fracture of tibia-fibula or hematogenous osteomyelitis with a large sequestrum. 15 cases had good results with good hypertrophy of bone after union. One case had poor result with fracture going into delayed union with no hypertrophy. We discuss the technique, complications and results of this procedure.
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Morbid Obesity (MO) is associated with various pathophysiological changes which affect the outcome of anaesthesia and surgery. We report here anaesthetic management of a fit morbidly obese patient for transcervical resection of endometrium (TCRE) under spinal subarachnoid block. The preoperative preparation, intraoperative and postoperative management is described and the various problems in morbidly obese patients are discussed.