Journal of clinical and diagnostic research : JCDR
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Aim of this paper is to report a case of extrusion of Ventriculo peritoneal shunt tube through anus in a one year female child ( k/c/o dandy walker malformation ) treated with placement of ventriculo peritoneal shunt for post operative hydrocephalus after excision of Subtorcular occipital meningocoel. The exact cause of such extrusion is not known. ⋯ The possible factors responsible for this complication are thin bowel wall in children, sharp and stiff end of the VP shunt, use of trocar by some surgeons, chronic irritation by the shunt, previous surgery, infection and silicone allergy. In view of the potential for meningitis prompt and aggressive management is essential to avoid morbidity and mortality.
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Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. ⋯ On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic.
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Gender related differences on morphine consumption during postoperative period following abdominal surgeries. ⋯ We conclude that men require more morphine in the postoperative period than women.
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Review
Mannitol an adjuvant in local anaesthetic solution: recent concept & changing trends (review).
Various adjuncts have been utilized with lignocaine to decrement tourniquet pain and prolong postoperative analgesia and its efficacy during dental extraction and various other restorative procedures in dentistry. An obligatory part of the dental process is to sanction a patient to feel comfortable and pain-free during operational and remedial dental procedures. The most popular local anaesthetic injection for lower teeth is the inferior alveolar nerve (IAN) block. ⋯ The goal of cumulating different drugs is to engender the best therapeutic effects with the fewest or no unpropitious effects. There are fewer researches and evidence present which recommend and promote the application and effectiveness of mannitol other than in the administration in decreasing raised intracranial pressure. It is paramount to know how the drug interacts with each other to minimize the unexpected or perilous effects.
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Spinal trauma is relatively more common in young active individuals. Although its mortality is low, it is an important cause of long term disability. Magnetic resonance imaging (MRI) can accurately depict presence and extent of spinal cord injury (SCI) in these patients. This study was aimed to look for various qualitative and quantitative MRI findings which are predictive of initial neurological deficit in patients with spinal trauma and final outcome on follow-up. ⋯ MRI is excellent imaging modality for detecting and assessing severity of spinal trauma. In our study, presence of cord haemorrhage, MCC and cord oedema were best predictors of baseline neurological status at presentation, whereas baseline ASIA score and cord haemorrhage were best predictors of final neurological outcome.