The coronavirus disease pandemic has affected our practice as healthcare professionals. As burn surgeons, we are obliged to provide the best possible care to our patients. However, due to the risk of viral transmission, the goal should be to provide safe care to our patients as well as ensure the safety of the whole team providing burn care. The burn patients are usually debilitated and require a prolonged hospital stay and multiple operative procedures which put them and everyone involved in their care at increased risk of coronavirus infections and transmission. This warrants special caution to the burn team while managing such patients. In this review, we aim to highlight the key considerations for burn care teams while dealing with burn patients during the COVID-19 pandemic.
HighlightsPatient presented as a case of appendicular perofration with pyoperitoneum leading to localized peritonitis which is a common surgical emergency.Primary omental torsion is a rare diagnosis and very difficult to diagnose at the emergency room.We report a patient with omental torsion and further gangrene of the omentum leading to pyoperitoneum mimicking appendicuar perforation peritonitis.A review of literature is also included.
The present investigation has been carried out to study if the Mycobacterium tuberculosis has any direct effect on granulosa cell progesterone production. Granulosa cells from pregnant mare serum gonadotropin (PMSG)-treated immature rats were incubated in replicates with and without the ultrasonicated Mycobacterium tuberculosis in the presence and absence of human chorionic gonadotrophin (hCG). Progesterone production and granulosa cell viability were assayed. The mycobacterial lysate significantly inhibited the basal production of progesterone. The lysate completely blocked the stimulatory effect of hCG. Any cytotoxic effect of the lysate was ruled out as none of the treatments decreased the viability of the granulosa cells as compared with the control values.
Objectives The objective of this study was to present the procedural details and digital subtraction angiography (DSA) findings of perioperative chest-wall collateral embolization (PCCE) and compare intraoperative blood loss in patients of pulmonary aspergilloma (PA) undergoing lung resection with and without PCCE. Materials and Methods Since November 2017, we have performed PCCE in 17 patients (14 males, three females, age 34.41 ± 12.85 years) before surgery for PA (embolization group). Retrospective evaluation of these patients was done, DSA findings were noted, and perioperative parameters (surgical approach, extent of resection, operative time, blood loss, blood transfusion, morbidity grade, and length of post-operative stay) were compared with a comparative cohort of 24 patients of PA (21 males, three females, mean age 36.13 ± 12.58 years) who underwent thoracic surgery without PCCE (May 2013–November 2017) (control group) using the Mann–Whitney U test. Results A total of 55 arteries were embolized in 17 patients (mean 3.23 arteries per patient). Technical success could be achieved in all patients without any procedure-related complications. The most common arteries embolized were posterior intercostal arteries (29) followed by costocervical trunk (10), superior thoracic (8), lateral thoracic (5), and internal thoracic arteries (3). The mean blood loss was significantly lower in the embolization group compared with the control group (676.47 vs. 1,264.58 mL, p = 0.015). Within the embolization group, patients who underwent video-assisted thoracoscopic surgery had even lower blood loss compared with open surgery cases (466 vs. 887.50 mL, p-value = 0.046). Conclusion PCCE is a simple and safe procedure, useful in reducing intra-operative blood loss in patients undergoing surgery for peripherally located PA.
Background. The prevalence and spectrum of interstitial lung diseases (ILDs) varies from region to region depending upon genetic and environmental factors.Methods. This was a descriptive observational study of 262 consecutive ILD patients diagnosed in the Pulmonary Medicine Department over a period of four years.Results. The mean age of the patient was 52.7±14.9 years; there were 120 males. All types of ILDs were more common in women except idiopathic pulmonary fibrosis (IPF) which was found predominantly (90.6%) in male patients. High resolution computed tomography (HRCT) showed definite usual interstitial pneumonia (UIP), possible UIP and inconsistent with UIP patterns in 50.4%, 9.5% and 40.1%, respectively. IPF was the most commonly found ILD (24.1%) followed by connective tissue disease related ILD (CTD-ILD) (22.1%), non-specific interstitial pneumonia (NSIP) (17.2%), hypersensitivity pneumonitis (HSP) (15.6%), sarcoidosis (7.6%), combined pulmonary fibrosis and emphysema (CPFE) (4.6%), cryptogenic organising pneumonia (4.2%), and occupational lung disease (2.7%), respectively. Bronchoscopic procedures were performed in 66 (25.2%) of patients which were diagnostic in 27 (44.9%); overall pathological diagnosis was possible in 10.2%. Univariate analysis showed smoking and hypothyroidism as statistically significant risk factors associated with IPF.Conclusions. Idiopathic pulmonary fibrosis was found as most common ILD; UIP pattern was seen in IPF, CTD-ILDs, chronic HSP and fibrotic NSIP.
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