Journal of the Indian Medical Association
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Osteo-arthritis is the chronic degenerative disease associated with joint pain and loss of joint function. It is caused by 'wear and tear' on a joint. Knee is the most commonly Involved joint. ⋯ Viscosupplementation may be a therapeutic option for individuals with osteo-arthritis of the knee. Viscosupplementation has been shown to relieve pain in many patients who cannot get relief from non-medicinal measures or analgesic drugs. This article is to know the mechanism of action, patients' selection criteria, rationale and efficacy of viscosupplimentation in the management of osteo-arthritis of knee.
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Posterolateral corner injuries of the knee are usually associated with injuries to other structures of the knee. It is not unusual to miss this injury during the initial assessment. ⋯ Failure to recognise and reconstruct posterolateral corner injuries is one of the important reasons for the failure of cruciate ligament reconstruction surgery. In this article we have reviewed the literature regarding anatomy, biomechanics, clinical features and treatment of the posterolateral corner injuries of the knee.
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Delirium (acute confusional state) is one of the most common mental disorders encountered in patients with medical illness, particularly among those who are older. It is associated with many complex underlying medical conditions and can be hard to recognise. Systematic studies and clinical trials are difficult to perform in patients with cognitive impairment; recommendations for evaluating and treating delirium are based primarily upon clinical observation and expert opinion. Our knowledge of the clinical epidemiology of delirium has substantially increased in the last decade, providing a basic framework for understanding and managing the disorder.
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Peripartum cardiomyopathy is an unusual form of dilated cardiomyopathy, which manifests as acute heart failure in the last trimester of pregnancy or early postpartum period. Its aetiology is currently unknown. The presenting signs and symptoms are those of congestive heart failure and more specifically those of left ventricular failure. ⋯ The goals of anaesthetic management include avoidance of drug induced myocardial depression and prevention of increases in ventricular preload and afterload. Vigilant monitoring is essential throughout the surgery and in the postoperative period and the need for invasive monitoring should be assessed according to the clinical condition of the patient. It is important to recognise the association of cardiac failure and pregnancy as a separate syndrome so that peripartum cardiomyopathy can also be kept as a differential diagnosis for cardiac failure occurring in the peripartum period and a high index of suspicion should be maintained for the timely detection and management of this condition.