Should Preoperative Computed Tomography Be Routine Examination For Cervicofacial Space Infections?

Background: Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections.Methods: A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed. Patients were divided into 2 groups: the group with preoperative CT and the group without preoperative CT. Outcomes, including re-operation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed.Results: Of 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The re-operation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P<0.05) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate, days of symptom relief, length of stay, and duration of surgery (P<0.05) were detected in the preoperative CT group. Conclusions: Preoperative CT examination should be recommended as a routine examination in the treatment of cervicofacial space infections for its usefulness in reducing the missed diagnosis rate and repeated surgery complication.

Surgical treatment of thromboembolia in the heart right atrium in pregnant women

Two clinical cases of surgical treatment of cardiac right-chamber thromboembolism in pregnant women are described. Thromboembolism was diagnosed during a routine examination. In the first clinical case, considering the late pregnancy, a thromboembolectomy was performed under artificial circulation after surgical delivery.In the second case, thrombus removal from the right atrium was performed on a working heart, without interruption of pregnancy. The surgical and postsurgical period proceeded without any specific features and the patients were discharged from the hospital without any complications. These clinical cases show that it is possible to remove thrombus from the right heart chambers without the use of extracorporeal circulation, which is also safe for the mother and the fetus.

Radiological study of the nasal septal body

Objectives The nasal septal body (NSB) is the thickened area of the septum located superior to the inferior turbinates and anterior to the middle turbinates. NSB contributes to nasal breathing via functionally and anatomically. The aim of the present study was to analyze NSB size and its association with such variables as age, septal deviation, and nasal turbinate size Material and Methods This retrospective study included 381 randomly selected patients that underwent paranasal sinus CT between 2014 and 2019. NSB size, septal deviation angle, and middle and inferior turbinate size were analyzed. Results NSB, inferior turbinate, middle turbinate, and inferior turbinate-P were significantly smaller on the deviated side. NSB, inferior turbinate, middle turbinate, and inferior turbinate-P size according to nasal septal angle was also significantly smaller on the deviated side. NSB and inferior turbinate size was positively correlated. Conclusion The NSB is an important structure for the regulation of air flow in the nose and should be evaluated in routine examination of the nose especially before the nasal surgery.

Difference between penetrating versus blunt ocular trauma in diagnosis, treatment and complications

Ocular trauma can be broadly classified into open and closed injuries. However, many subclassifications were reported based on the causative object and extent of the injury. The diagnosis and management of the various ocular traumas are different based on the underlying etiology, the severity of the case and the potentially related complications. Accordingly, in the present study, we aimed to conduct a thorough discussion about the diagnosis, treatment, complications of the blunt and penetrating ocular traumas and the potential differences between the two types of injuries. Our findings indicated that the diagnosis of the conditions mainly differed in the step of obtaining an adequate history from the affected patients based on the diagnosis of the condition that can be established. Furthermore, a routine examination should also be performed for both cases to enhance the prognosis and preserve vision. In addition, prognosis is usually worse in cases of penetrating or perforating injuries where eye inoculation might be indicated in severe cases. A detailed description of this information is provided within the manuscript based on the etiology of the underlying ocular injury and the related prognostic outcomes.

Dilatated Cardiomyopathy In Two Month Old Puppy

Background: Canine dilated cardiomyopathy (DCM) is a disease that results in a decreased ability of the cardiac contraction to generate pressure to pump blood through the vascular system. DCM is characterized by dilation of the ventricles with ventricular wall thinning. Purpose: The DCM case in Indonesia is rarely reported; therefore, this paper contains information about dilatated cardiomyopathy in a 2-month-old puppy. Case Analyze: A two-month-old local dog arrived with a complaint about coughing, loss of appetite, fatigue, and swelling on extremities, also having a history of seizures and bloody diarrhea. Physical examination shows that the patient breathes using abdominal type and polypnea, tachycardia pulse, pale mucose, and dehydration. Electrocardiogram result shows tachycardia sinus and abnormality in the depression of ST-segment. Radiography examination shows heart dilation and liquid accumulation in the thoracic cavity and abdomen. Hematology routine examination shows microcytic hyperchromic anemia, leucocytosis, and eosinophilia. Feces examination resulted in negative. Pathology anatomy examination show dilatated cardio, pulmonum hepatization, fluid accumulation in the thoracic cavity and abdomen cavity. Result: According to anamnesis, clinical examination, laboratory examination, and anatomy pathology examination can be concluded that the dog, in this case, is diagnosed with dilatated cardiomyopathy.

Oral Manifestations of a Patient Suffering from a Rare Gilbert’s Syndrome: A Case Report

Gilbert's syndrome is a rare genetic disorder characterized by abnormal glucuronidation of bilirubin in the liver, presenting as unconjugated hyperbilirubinemia in the absence of hepatocellular injury or hemolysis. Diagnosis of this pathology is primarily made during routine examination described as the presence of a yellowish tinge in the eyes and skin in general. Normally, the oral manifestations of Gilbert's syndrome are present but mostly go unnoticed as the teeth are minimally affected which are visible to the patient and surrounding mucosa in the oral cavity, where yellow discoloration can be appreciated. Dental treatments are smoothly carried out for such patients like extractions, root canal treatment, cleaning prophylaxis. The patient in this case safely underwent the root canal treatment after being diagnosed with irreversible pulpitis without any unusual discomfort. Local anesthesia can also be safely administered to such patients such as infiltration and inferior alveolar block anesthesia.

Efficacy of Albendazole Against Strongylus sp. and Hematology Changes on Equine in Yogyakarta Special Region

The infestation of Strongylus sp. in horses can cause losses to horse breeders, including anorexia, anemia, gastrointestinal diseases and can cause death and decrease the horse population in DIY. Albendazole was a Benzimidazole preparation that is often used to treat worms in ruminants. This study also aims to determine the effect of Albendazole on blood images before and after treatment. The material used in this study were 10 horses with male and female sex, over 3 years old, and infected with Strongylus sp. with an infestation rate of 200 EPG in faeces. Before treatment of drug was carried out, the faeces was examined with Mc Master method. After treatment with Albendazole, the worm eggs were examined three times at intervals of three days. Routine examination of worm eggs and blood was carried out at the Laboratory of the Department of Internal Medicine, Faculty of Veterinary Medicine, Universitas Gadjah Mada. The results showed that the EPG number decreased from the 0th, 3rd, 6th and 9th day of examinations. The average number of EPG on the 0th day was 990 eggs/gram, and the examination on the 9th day showed the number of eggs was 0 eggs/gram. The results of the hematology examination also showed no significant difference except for the high number of eosinophils on the 12th day after drug administration. The conclusion from this research is that Albendazole as a worm medicine can kill Srongylus sp. however, it does not affect the horse's hematology and health status.

A MANAGEMENT OF YAKRIT VRIDDHI (HEPATOMEGALY) BY SHODHANA CHIKITSA (VIRECHANA) FOLLOWED BY SHAMAN CHIKITSA (ARKA MAKOI): A CASE STUDY

A 39-year-old man with clinical sign and symptoms of poor appetite, nausea, fatigue, distend abdomen, increased abdominal size and shape, abdominal pain, indigestion, vomiting sensation diagnosed as Yakrit Vriddhi or Yakrit-dalodar (Hepatomegaly). As per Ayurveda Samhita Shodhana Chikitsa is more effective in such type of patient. In this case after the routine examination i.e., History, Palpation, Blood Investigation (LFT), and Ultrasonography patient was treated by Panchakarma treatment. (Bio-purification therapy) In this Poorva Karma (Snehan- Bahya/Abhyantara) and Pradhana Karma (Abhayadimodak - Virechana Karma) in which vitiated doshas were expelled through Adhomarga (Anal route). After the Virechana Karma for restoration of the body Sansarjana Karma (Ayurvedic Dietary & Behavior regimen) was also done. The patient was on purgation 26 times (Vegas). At the end of the virechana karma Kapha was presented in the stool (Kaphant-Virechana). After the complete procedure followed by palliative treatment with Arka Makoi (Solanum nigrum) patient felt remarkable relief from above cited symptoms i.e., poor appetite, nausea, fatigue, distend abdomen, increased abdominal size and shape, abdominal pain, indigestion, vomiting sensation. The therapeutic purgation is safe and effective Panchakarma protocol to eliminate the morbid Pitta Dosha in the body either by pathological condition or diet and behavioral mismanagement.

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Background: The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) in patients qualified for bariatric surgeries are still a matter of debate. The aim of this study was to analyze the pathologies on preoperative EGD in patients qualified for bariatric surgeries. Materials and Methods: This study included 222 patients, divided into two groups. The obesity group consisted of patients with obesity (BMI ≥ 40 kg/m2), for whom EGD was a routine part of the preparation for laparoscopic sleeve gastrectomy (LSG). The control group of patients with normal body weight (BMI) qualified for EGD because of gastrointestinal ailments. Results: Regarding preoperative EGD in patients qualified for bariatric surgeries, we analyzed the prevalence of endoscopic pathologies in various gastrointestinal tract segments. Patients with obesity were shown to present with esophageal pathologies significantly more often than persons in the control group (n = 23, 20.91% vs. n = 12, 10.91%, p = 0.042). The odds ratio of esophageal pathologies in patients with obesity versus the control group equaled 2.15 (95%CI: 1.01–4.59). In turn, the odds ratio of duodenal pathologies in patients from the control group was 3.31 (95%Cl: 1.16–9.47), which means that persons from this group were approximately three times more likely to be diagnosed with those pathologies compared to obese patients. Moreover, patient sex was a significant predictor of duodenal pathologies, with an odds ratio of 4.03 (95%CI: 1.53–10.61). Conclusions: Preoperative EGD can identify a broad spectrum of pathologies in obese patients, which suggests a routine examination before bariatric surgery.