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Reinforcement of Sliced Tragal Cartilage Perichondrium Composite Graft with Temporalis Fascia in Type I Tympanoplasty: Our Techniques and Results
No full textAbstract: In our otological practice, we prefer sliced tragal cartilage- perichondrium grafting for reconstruction of the tympanic membrane perforations. In an attempt to reduce residual and recurrent perforations in our series of cartilage tympanoplasty using sliced tragal cartilage perichondrium composite graft, we reinforce tragal cartilage with temporalis fascia in large perforations. Aim: The purpose of this study is to evaluate anatomical and audiological results after primary cartilage tympanoplasty using sliced tragal cartilage reinforced with temporalis fascia in large perforations.Methods and Materials: We carried a prospective study of 28 patients operated from March 2010 to January 2011 in M.I.M.E.R Medical College and Sushrut ENT Hospital using sliced tragal cartilage reinforced with temporalis fascia. The surgical technique is described in detail.Results: Successful closure of the tympanic membrane was achieved in all patients at 2 years of follow up. The average postoperative Air Bone Gap was 9.6429+/-2.6557 dB. Conclusion: Reinforcement of temporalis fascia with sliced tragal cartilage is a reliable technique for tympanoplasty, especially in large perforations. To our knowledge, this is the first study involving the reinforcement of sliced tragal cartilage with temporalis fascia in type I tympanoplasty
Total Glossectomy: Is Gracilis Free Flap the Answer to the Functioning Neotongue?
No full textAbstract: The proper management for the advanced carcinoma of tongue has not been explained in texts and for long the treatment of choice varied from center to center. In our study the aim was the complete removal of the malignancy and at the same time tongue reconstruction was done. Three patients with advanced carcinoma tongue were managed with total Glossectomy and neck dissection followed by reconstruction with gracilis free flap. This provided the long survival with the least morbidity
Acute Syphilitic Balanitis and Gross Penile Edema in an HIV-Infected Man
No full textSyphilis presenting with balanitis and penile edema is rare, and in most cases has been considered to be a manifestation of primary syphilis. We report the case of an HIV-infected man who presented with penile edema and balanitis concomitant with an eruption on his buttocks, lower abdomen and thighs. Histologic examination and serology were diagnostic of syphilis, and the patient was successfully treated with benzathine-penicillin. Our case represents an unusual, infrequently reported presentation of secondary syphilis
Editorial
No full textInaugural issue of International Journal of Clinical Psychiatry in Mental Health
Assessment of Coronary Artery Calcification in Elderly Adults
No full textBackground: Early identification of atherosclerosis in older adults is paramount due to high cardiovascular morbidity and mortality. Our aim was to investigate CAC in a population of adults ≥55 years without previous history of cardiovascular heart disease (CHD) and its association with cardiovascular risk factors.Methods: This was a retrospective analysis of 6,573 individuals with a mean age of 61.8 years (range 55-85; 68.2% males) who underwent Electron Beam Computed Tomography for CAC score (CACS) assessment.Results: CAC was present in 70.5% of the overall cohort (78.8% of males and 52.7% of females). Twenty six per cent (26%) of those with CAC did not have any CHD risk factors. CACS ranged from 0 to 7,908 (mean 223.3±512.9); males presented a higher mean CACS (284.57 ± 571.1), compared to females (mean CACS 92.2 ± 324.8), p<0.0001. The mean CACS in males increased from 154.2 for ages 55-59 years to 760.2 in those aged 80 to 84 whilst in females mean CACS increased from 39.5 to 224.4, for corresponding age groups. The mean CACS appears to increase with age irrespective of gender.In each gender, age and hypercholesterolemia were associated with higher CACS. Furthermore, in males family history and DM were positively associated with CACS while in females, smoking status and hypertension were positively associated with CACS.Conclusion: A broad distribution of CACS was seen in older subjects. Assessment of CACS may place patients into a higher risk group for future events, and lead to more aggressive treatment with preventative therapies
Progressive Tumoral Calcinosis in a Haemodialysis Patient Despite Medical and Surgical Therapy
No full textTumoral calcinosis is an unusual metabolic complication that is uncommonly seen in chronic dialysis patients with deranged calcium and phosphate metabolism. We report a case that was resistant to medical and surgical treatment, which eventually led to septicemic shock and death. This case highlighted to importance of routine surveillance with radiographic and physical examination of musculoskeletal system in high-risked susceptible dialysis patients, even in the absence of warning signs and symptoms
Unusual Intravesical Foreign Bodies and their Management
No full textObjective: The objective of the study was to evaluate the difficulties in diagnosis and management of various intravesical foreign bodies.Material and Methods: Retrospective review of patients with unusual intravesical foreign bodies presented at department of urology, from January 1992 to August 2011.Their record were reviewed for age and sex, clinical presentation, investigations, and treatment offered. All patients underwent evaluation including history, physical examination, ancillary testing as indicated and subjective symptom appraisal.Results: Age of the 25 patients (male female ratio, 1.7:1) in study group varied from 1 to 65 years (mean age, 34.2 years). Nineteen patients (76%) had iatrogenic foreign bodies including retained corrugated rubber sheet in 1, a piece of a Foley balloon catheter in 7, cu- T wrongly put in urethra in 1 patient, cut end of Foley’s catheter in 3, fractured segment of Foley’s catheter in 1 patient, thread pieces in 1, Malecot rubber piece in 1and DJ stent in 4 patients. All of these patients had undergone some surgical intervention or urinary tract manipulation at peripheral hospitals and presented at variable intervals after the primary intervention. Four patients (16%) had migratory foreign body and 2 (8%) had self inserted foreign body. The most common presenting symptoms were urinary frequency, and dysuria. Endoscopic retrieval was possible in 11 (44.0%) patients, percutaneous cystolithalopaxy with removal of foreign body was possible in 7 (28%) and the remaining 7 (28%) underwent open cystostomy. None of the patients had any postoperative complicationsConclusion: Intravesical foreign bodies should be included in the differential diagnosis of patients presenting with chronic/recurrent lower urinary tract symptoms after previous history of pelvic surgery, instrumentation or IUCD insertion. Radiological evaluation is necessary to determine the exact size, number, and nature of foreign bodies and associated complications like stones. Most intra vesical foreign bodies can be retrieved with endoscopic and minimally invasive techniques
Auto-Digestion of Penis after Ring Block with Xylocaine & Adrenaline: A Lethal Iatrogenic Trauma
No full textA 10 years old insulin dependent diabetic male child presented with gradual blackening of penis and ketoacidosis after incision and drainage of abscess at penile shaft under penile ring block with xylocaine with adrenaline. Patient was managed for diabetes, debridement and SPC was done but process of gangrene continued; finally whole penis slough out. Perineal urethrostomy was done and patient was advised for penile reconstruction later on