Surgical and anesthetic management of primary dumbbell shaped spinal hydatid cyst in lumbar vertebra: A rare case report

Hydatid cyst is a very significant health problem in India. As recorded in the literature, majority of hydatid cysts are found in the liver followed by the lungs with an incidence rate of 60-70% and 10-15% respectively. Cystic hydatid disease in bones is seen in less than 4% of cases, with majority presenting in the spine. In this case report we have discussed primary intraspinal extradural hydatid cyst with paravertebral extension (dumbbell shaped) in lumbar vertebra which is a rarity. The diagnosis was established intraoperatively based on the findings with a follow up and review of literatures, along with its management.

Ritual circumcision by inexperienced hand some time cause penile amputation

Ritual circumcision is a custom. But, when it is done by inexperienced person, it may cause painful situation for parents.: We are presenting a case of ritual circumcision done by inexperienced person. Complete amputation of glans was occurred during circumcision. That was very painful situation for parents. To avoid such complication circumcision should be done by experienced medical practitioner or training should be provided to the persons who are doing ritual circumcision.

The diagnostic dilemma of Masticator space tumor

The masticator space is an anatomical and functional entity centered on the mandibular ramus, which divides it into medial and lateral compartments. The masticator spaces considered paired supra-hyoid cervical spaces on each side of the face that extend from the angle of the mandible to the parietal bone. The masticator space contains the mastication muscles, posterior mandible, and mandibular nerve. They are separated from the nasopharynx by the parapharyngeal spaces bilaterally. Primary malignancy of the masticator space is very uncommon.Here we report a diagnostic dilemma of primary masticator space malignancy mistaken by nasopharyngeal carcinoma as the patient 40-year old gentleman presented with left lateral rectus palsy and left nasopharynx fullness.

Malignant peripheral nerve sheath tumor of anterior abdominal wall- A rare presentation

Malignant peripheral nerve sheath tumor is highly malignant tumors that occur most commonly in head and neck as well as extremities. Very rarely it seen in the retroperitoneum. When associated with neurofibromatosis, they are having a poor outcome. We present a case malignant peripheral nerve sheath tumor of anterior abdominal wall. The location and rapid increase in size of the swelling permitted early diagnosis and treatment.

Morphometric analysis of pre and post operative facial angles following rhinoplasty

Facial aesthetic surgery requires a thorough preoperative analysis of face and identification of problems to frame a comprehensive surgical plan. The conceptions of an attractive face must be analyzed beforehand. Powell and Humphrey had defined facial angles and had formulated range which would be perceived as attractive. To compare the change in pre- and post-operative nasolabial, nasofrontal and nasofacial angles in patients undergoing Rhinoplasty. A prospective observational study was conducted from October 2014 to October 2019 in ENT department of a tertiary care hospital. Twenty-one patients undergoing Rhinoplasty and fulfilling the inclusion criteria were considered as study population. Their pre- and post-operative profile photographs were taken for morphometric analysis. The nasolabial, nasofrontal and nasofacial angles were measured and compared, before and one month after the surgery in profile pictures. A significant change in the nasolabial and nasofacial angles were seen following Rhinoplasty. The mean nasofrontal angle showed an increase following Rhinoplasty but was not found significant. Rhinoplasty results in significant change in nasofacial and nasolabial angles and in expert hands, is expected to restore the various facial angles to their acceptable range.

Importance of proper diet after thyroidectomy in diabetic patients: A short communication

Thyroidectomy is a surgical technique used to treat cancer, noncancerous thyroid enlargement, goiter, and hyperthyroidism. It is a procedure to remove all or sections of the thyroid gland. Most importantly, some common complications are often observed, like weight gain, loss of libido, and vocal cord paresis or paralysis after thyroidectomy. After surgery, diabetic patients are more prone to comorbidities such as kidney disease, eyes health issues, hypertension, obesity, etc. This study highlighted the probable diet and essential home-based nutrition for post thyroidectomy complications. Weight gain is the common complaint of most patients who underwent surgery. Currently, there are insufficient data that do not provide clear conclusions about post-surgery diet plan. However, low carbohydrate, low fat but high veg-protein-rich diet are altogether helpful for weight loss, diabetes, and related complication. More research is needed in the medical nutrition therapies segment to get more dietary options for such patients.

Role of cefuroxime as antibiotic prophylaxis for general surgery: An expert opinion

Surgical site infections (SSIs) are serious postoperative complications reported globally, which lead to perioperative antibiotics use during routine practice in surgical procedures. Selection of appropriate antibiotic/s for prophylaxis is a vital step in the management and care of invasive surgical procedures. This expert opinion review was developed based on expert discussion and literature search on scientific databases with special emphasis on cefuroxime in surgical prophylaxis for general surgeries. Cephalosporins are globally considered to be the drugs of choice for surgical prophylaxis in general surgeries owing to good safety, bactericidal activity, penetration to critical tissues, and proven efficacy in clinical trials. Cefuroxime, a 2nd generation cephalosporin, is an effective, safe and low-cost antibiotic for surgical prophylaxis in general surgeries, in particular for patients who need sequential antibiotic therapy. Cefuroxime can be administered alone or in combination with other classes of antibiotics based on clinical characteristics of individual patients and surgeon’s discretion to reduce the risk of postoperative SSIs, abscess, septicemia, and microbial growth. Cefuroxime can be administered alone or in combination with other classes of antibiotics based on clinical characteristics of individual patients and surgeon’s discretion to reduce the risk of postoperative SSIs, abscess, septicemia, and microbial growth.

Toxoplasmosis presenting as isolated cervical lymphadenopathy-A rare case

Lymphadenopathy is not uncommon in toxoplasmosis. Its rare in an immunocompetent patient. We present a case of toxoplasmosis in an asymptomatic lady with isolated cervical lymph node. The diagnosis was confirmed by excision biopsy of lymph node and serology

Discussions on hypospadius repair

Surgery for Hypospadius is fraught with complications. The very fact that there are more than a hundred techniques described for this problem is evidence enough to confirm that no single technique is the perfect answer to our efforts. The presenting author is a student of Dr.H.S.Asopa and an advocate of the perpucial island flap technique, though not dogmatic in its propagation. He has also had the opportunity to train with Mr. Aviar Bracka and uses different techniques judiciously. This presentation is about the details no author stresses upon for Hypospadius and surgery. Pre and post operative pictures are not the only teaching aids. Ten Commandments for Hypospadius surgeons. These are in themselves self explanatory for the students of Hypospadius as well as the senior specialist. We have been achieving consistant results even though we have not struck to any one technique. We have been using the modified Asopa-I technique (for almost half the cases) and Bracka technique as the two main methods for surgery. This step by step on pitfalls in hypospadius surgery is not to highlight surgical techniques but to discuss about steps which have their own importance to produce acceptable results.In spite of so many methods to perform surgery for patients of hypospadius, some general principles on tissue handling, suture management, prevention of edema, general method of dissection, dressing techniques etc go a long way in giving consistant results whatever the method used for the repair.

Serial estimation of serum myeloperoxidase in patients of acute pancreatitis: A pilot study

Acute pancreatitis (AP) is an inflammatory condition having varied presentation ranging from a mild self-limiting illness to a severe disease with multi organ failure. Excessive recruitment of leukocytosis is an important pathophysiological feature and Myelo-peroxidase (MPO) forms an important part of neutrophil induced inflammation. The current prognostic criteria are complex and cumbersome.: The present cross sectional pilot study serial estimation of plasma MPO levels were done at the time of admission and on 3, 7 and 14 days in patient of Acute Pancreatitis (n=64) patient with acute abdominal symptoms (n=15) otherthan acute pancreatitidand healthy volunteers (n=15). The values of serum MPO levels were correlated with Ransons`s score, Apache score, CT severity index and patient developing local and systemic complications due to acute pancreatitis. Serum MPO levels in (mU/ml) were measured by colorimetric Assay kit (bio Vision, USA). Statistical Analysis on SPSS (Windows version 21.0): The mean serum MPO levels were significantly high in patients of AP as compared to controls comprising of patients with acute abdominal conditions and healthy individuals (mean 12.73 vs 1.67 mU/ml. p< 0.001). The highest levels of serum MPO were observed on the first day of mild and severe AP. The mean MPO levels in mild diseases (n=21 patients) were 3-10 mU/ml and 10-20 mU/ml in severe AP (n=43 patients) who also experienced higher local complications and worse outcome in terms of mortality. MPO returned to normal levels within 7-10days in mild but were persistently raised in patients with severe diseases. The higher serum MPO levels correlated with more severe diseases, worse outcome and can be a simple and effective prognostic indicator in AP.