The recognition of unusual yeasts as an agent of life-threatening infection and their intrinsic resistance increases the burden on the mycology laboratory for complete species identification and to determine minimum inhibitory concentration.
Use of the first-generation TriGuard EDD during TAVR is safe, and device performance was successful in 80% of cases during the highest embolic-risk portions of the TAVR procedure. The potential of the TriGuard EDD to reduce total cerebral ischaemic burden merits further randomised investigation.
68 Ga-Prostate specific membrane antigen-N,N′-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N ′-diacetic acid-positron emission tomography/computed tomography or 68 Ga-HBED-CC-PSMA PET/CT, popularly known as PSMA PET/CT, is able to detect a small volume of recurrent prostate carcinoma (PC) when there is a prostate specific antigen (PSA) rise on follow-up after prostatectomy or other definitive treatment for PC. The use of PSMA PET/ CT in the initial staging in PC is uncertain at this time. Clinical studies are underway to define its exact role in the management of the disease. At the same time it is important to be aware of unexpected sites of uptake of this ligand. We present here the case of a 62-year-old male patient who underwent prostatectomy for adenocarcinoma prostate. He also had a long-standing left solitary thyroid nodule (STN). Four months after surgery, he had a rising trend in serum PSA levels on three occasions, but the absolute value was less than 4 at all times. He underwent a 68 Ga-PSMA-HBED-CC PET/CT, but it did not reveal any recurrent/metastatic site of disease. However, there was increased tracer uptake in the left STN.Fine needle aspiration cytology revealed features of atypia of undetermined significance, Bethesda category III. The patient underwent a left hemithyroidectomy and the histopathology showed features of a follicular adenoma.
Background & Objectives: The superior hypogastric plexus block (SHPB) has been extensively used for treating pelvic cancer pain and chronic pelvic pain, but not as a modality of postoperative analgesia. Currently, postoperative analgesia following gynecological laparotomies is managed mainly by parenteral NSAIDS, opioids or by epidural block. We propose that the intraoperative superior hypogastric plexus block could be a safe and an effective method for managing postoperative pain in patientsundergoing gynecological laparotomies.Methodology: It was a prospective randomized case control study. Sixty female patients of ages 18-60 y belonging to ASA grade 1 and 2 undergoing gynecological laparotomies were allocated equally into two groups, study and control group. Both groups received general anesthesia. At the end of surgery, the Study Group received. Postoperative pain was assessed with VAS score, patient’s vital parameters and amount of morphine consumed by patient controlled analgesia at 0, 2, 6, 12, 24 and 48 h.Results: The VAS score for pain showed significant difference between Study Group and Control Group at 0 h (p = 0.033), 2 h (p < 0.0001), 6 h (p < 0.0001), 12 h (p < 0.0001) and 24 h (p = 0.003) but not at 48 h (p = 0.085). This showed that the block was more effective up to 24 h. There was significant difference of 33.6% (p < 0.0001) in morphine consumption between study (36.03 mg) and control (54.33 mg) groups.Conclusions: We conclude that superior hypogastric plexus block is a simple, safe and effective without any major complications and has a short learning curve. It has a high success rate for majority of gynecological laparotomies.Citation: Subramanian V, Aggarwal S, Kale S, Parthasarathy AH, Batra A. Intraoperative superior hypogastric plexus block for postoperative pain following gynecological laparotomies. Anaesth. pain & intensive care 2019;23(2):157-161
We report a case of congenital renal tuberculosis in a 34-day-old child presenting as severe hematuria. Adequate antitubercular treatment may provide protection to fetus in subsequent pregnancies.
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