Laparoscopic splenectomy is now the gold standard for patients with idiopathic thrombocytopenic purpura (ITP) undergoing splenectomy. There are a few reports in literature on single-incision laparoscopic (SIL) splenectomy. Herein, we describe a patient undergoing SIL splenectomy for ITP without the use of a disposable port device. We report a 20-year-old female patient with steroid-refractory ITP having a platelet count of 14,000/cmm who underwent a SIL splenectomy. Dissection was facilitated by the use of a single articulating grasper and a gastric traction suture and splenic vessels were secured at the hilum with an endo-GIA stapler. She made an uneventful postoperative recovery and was discharged on the second postoperative day. She is doing well with no visible scar at 8-month follow-up.
ELDOA is a revolutionary technique for improvement of health and longevity of the spine which is introduced by French osteopath; Guy Voyer. The primary goal of ELDOA is to apply focused internal tension and load to decrease pressure on the discs of spine, increase blood flow and to reduce pain at cervical spine. There is little high-quality evidence on best no operative therapy for cervical radiculopathy. Objective: To determine the effects of Modified ELDOA technique in patients with cervical radiculopathy in terms of pain, nerve tension and disability. Methods: Thirty patients were randomly assigned either to a group that performed modified ELDOA along with conventional treatment aimed at decreasing the effects of pain, nerve tension and disability or to a group that performed ELDOA and received conventional treatment having the same goal as the former. Randomized controlled trial was selected as the design of study. Treatment protocol of control group included hot pack, TENS, PIR(MET) 4 reps with 6 sec hold, Maitland oscillations (20 reps in 3 sets), ELDOA at cervical spine, Neurodynamic stretching of involved nerve. Treatment protocol of experimental group included hot pack, TENS, PIR(MET)4 reps with 6 seconds hold, Maitland oscillations (20 reps in 3 sets), modified ELDOA at cervical spine, Neurodynamic stretching of involved nerve. Each patient received 8 sessions on alternate days covered in a total span of 16 days. Assessments were done at 1st 8thsession.The tools used were NDI, NPRS and ROM through goniometer. IBMSPSS-21 was used to analyze data. Results: The results demonstrated that treatment protocols of both the control and experimental groups have significant effects on reducing pain, tension and disability and improving mobility of cervical spine. Whereas, for difference in effectiveness of modified ELDOA and ELDOA, the overall p-values came out to be >0.05 while comparing the end values of both groups, showing that there is a non-significant difference in the effects of ELDOA and modified ELDOA. Conclusion: Modified ELDOA works effectively in posture correction hence improving the functional status of patient. Modified ELDOA and ELDOA postures help in treatment of cervical radiculopathy. The effectiveness of ELDOA and modified ELDOA has a non-significant difference.
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