Niger J Clin Pract
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Review Case Reports
Retained lumbar intradural bullet fragment with neurological recovery after delayed removal of bullet: Case report and literature review.
Civilian gunshot wound (GSW) to the spine is expected to increase in our environment due to the recent surge in violence and firearm attacks in the society either by herdsmen, bandits, unknown gunmen, or from exchange of gun fire with security personnel in response to insecurity issues. The management of GSW in the spine remains controversial, with no clear recommendations for surgical intervention by spine surgeons. In light of this, we report a case of civilian GSW to the lumbar spine in a 47-year-old female with resultant immediate paraplegia. ⋯ She underwent laminectomy and duratomy with removal of the bullet. Motor function returned 3 weeks after the surgery, and she was discharged home 8 weeks after the surgery, actively mobilizing on a Zimmer frame. The case report demonstrates the beneficial role of surgical intervention in properly selected patients, with resultant satisfactory functional neurological recovery.
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We aimed to present our anesthetic management for an ultrasound-guided (USG) interscalene block in the presence of a new brachial plexus variation in a 59-year-old male patient underwent shoulder arthroscopy. An accessory muscle between the anterior scalene (ASM) and middle scalene muscle (MSM) was viewed via ultrasound. When four roots that the accessory muscle separated into two groups, which should be normally present between the ASM and MSM were displayed, we decided to use nerve stimulator to perform block. ⋯ For interscalene block, 30 ml of 0.375% bupivacaine was used via multi-injection. We confirmed this new brachial plexus variation with magnetic resonance neurography for the first time in a patient. Interscalene block should be definitely performed under USG and when a new anatomical variation is suspected, roots should be separated with a nerve stimulator to increase the success of the block.
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Although there is still no universally accepted treatment agent, steroids have been administered chronologically at every dose and at every stage of the COVID-19 pandemic. ⋯ We recommend steroids use in the condition that it is indicated in the critically ill group with the poor general condition. Since there is no significant difference between high-dose pulse steroid treatment and standard treatment doses, we think that the risk of complications should not be taken into account and high doses should not be used.
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During physiological root resorption of deciduous teeth, apoptotic cell death triggered by physiological processes might play a role in physiological root resorption in addition to collagen destruction. Little information has been obtained about the sequence of events and the mechanism responsible for the physiological death of pulp tissue cells. ⋯ The similarity between the AI values for both study groups suggested that in early and advanced stages of resorption, apoptosis may contribute to the regulation of the pulp cell population in a way that does not relate to the physiological process of deciduous teeth root resorption.
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Taking care of bedridden patients at home is a very difficult task for caregivers. In this care process, caregivers can be supported with the interventions given by the nurses at home. ⋯ Our study highlights that the burden and anxiety levels of the caregivers had lower post-test levels than the pre-test levels.