Thirty-one patients with suspected radiolucent foreign bodies (wooden splinters) in soft tissues of extremities were investigated by plain radiography, computed tomography (CT) scan and ultrasonography to the area suspected clinically. Ultrasonography detected and localized radiolucent foreign bodies in 18 of the 31 patients, while only 14 were seen on CT scan. Following surgical exploration, the presence of foreign bodies was confirmed in 20 patients; thus, the accuracy of ultrasonography was 90% while that of CT scan was 70%. The size of foreign body, the presence of infection or the delay in diagnosis had no effect on results. Ultrasonography is clearly a reliable method of detecting radiolucent foreign bodies in soft tissues of extremities. Ann Saudi Med 1995;15 (2) There are various modalities to detect and localize radiolucent foreign bodies in soft tissues, but none of these investigations independently could be considered entirely conclusive.1,2 This paper evaluates the role of ultrasonography to detect and localize nonradiopaque foreign bodies in soft tissues and compare its efficacies over other methods of assessment including clinical, radiographic and CT examinations. Patients and MethodsThirty-one consecutive patients complaining of suspected embedded thorns or wooden splinters in soft tissues of the limbs were investigated. There were 23 males and 18 females. The ages ranged between five years and 41 years (mean 22.8 y). The site of the thorn prick was in the foot in 20 patients, in the hand in three, in the thigh in three, in the forearm in three and in the legs in two patients.The following protocol was followed to detect and localize foreign bodies in the soft tissues before surgical exploration: All patients were clinically examined and the area in question was marked by a radiopaque marker and plain radiographic pictures were taken in two views. Ultrasonography was performed by a radiologist using 5 mHz, RT 3000 linear array transducer in water bath in two planes. Fresh wooden objects show up bright sonographically and cast a distal shadow. If these objects decompose, then secondary signs such as edema may accentuate the object by providing a hyperechoic halo. CT scan of the area was also carried out using 2 mm cuts which clearly distinguished the embedded thorn from the adjacent tissue. Following these investigations, the area in question was explored and the efficacy of each investigation was evaluated in relation to its accuracy in detecting and localizing the foreign bodies irrespective of their size and depth, the time factor and the presence of infection.
Background: Surgical fine needle aspiration cytology is most popular diagnostic aid in patients with lymphadenopathy.Methods: This one year observational study comprised of aspirate collected from lymph nodes of patients attending Mahamaya Rajkiya Allopathic Medical College and Hospital, Ambedkarnagar, Uttar Pradesh, India. Fine needle aspiration was performed in all the patients and slides were stained with H and E, PAP and Ziehl Neelsen stains. SPSS was used for data analysis. Fischer’s Exact test was applied.Results: Out of the 51 patients, the most common site of lymph node aspirated was cervical (72.5%). A higher proportion of cases were diagnosed as chronic nonspecific lymphadenitis (23.5%) followed by granulomatous abscess (23.5%), tubercular lymph node (21.6%) and reactive (17.6%). A significant association found between FNAC diagnosis and age was found (p≤ 0.05).Conclusions: FNAC is a simple and useful procedure in patients with lymphadenopathy.
We studied 43 patients with ipsilateral femoral shaft and femoral neck fractures who had dynamic hip screw fixation alone or in combination with dynamic compression plate. All patients except two were diagnosed early; 37 patients had other associated injuries. There were 41 males and two females. The follow-up ranged from eight months to four years (mean 2-1/2 years). Six patients were lost to follow-up. Fracture of the neck of the femur healed in all 37 patients. Four patients had delayed union and two patients developed nonunion of the shaft of the femur. A concomitant ipsilateral femoral shaft and neck fracture is uncommon [1]. It usually occurs in young patients. The mechanism of injury is not well known. It is associated with high velocity accidents and accompanied by multiple system trauma [2]. With advanced emergency facilities, most of these patients survive their multiple system injuries so they need definitive management for their fractures [3]. There is no standard method of fixation for such combined fractures. In this study, good results were obtained in those patients who had early diagnosis and fixation with a long plate dynamic hip screw alone or dynamic hip screw and broad dynamic compression plate. Patients and MethodsDuring the period 1987-1991, a total of 43 patients who had ipsilateral femoral shaft and neck fractures were treated by internal fixation. The implants used were either a long plate dynamic hip screw (DHS) holding both fractures or a dynamic hip screw for the fracture of the neck and a broad dynamic compression plate (DCP) for the fracture of the shaft (Figures 1 and 2). Cancellous bone graft from the iliac crest was added in 32 patients who had comminuted fractures or defects in the medial cortex, while 11 patients had no bone graft. In 41 patients, surgery was undertaken within the first two to seven days. This delay was mainly due to the blood donation policy implemented in the hospital. Two patients who were not initially diagnosed had surgery later on. Forty-one patients were males and two were females. The ages ranged from 25 to 70 years (average 38 years). All patients were involved in road traffic accidents. The type and site of fracture and the outcome of follow-up was considered. Surgical TechniqueThe patient was put on a hip fracture table. The femoral neck fracture was reduced by traction under image intensifier. Through a lateral approach, DHS was inserted in the femoral neck. If the fracture was in the upper onethird of the femur, both fractures were fixed by using a long DHS plate. If the femoral shaft fracture was in the middle or lower one-third, initially the femoral neck fracture was fixed with a short DHS plate; then traction was released and an extension table applied under the leg. Using a second incision, the femoral shaft fracture was fixed with a broad DCP which was applied in a different plane from the DHS plate.
The global widespread of Corona virus disease is still having a catastrophic impact on mankind. COVID-19 has depicted its uncertain adversity in all age groups and the coexistence of co-morbidities have further shown a critical aspect of disease which has additionally ravaged the health status of the patients. The inflammatory markers have exhibited potential usefulness in predicting the outcome of the disease. The Aim of this study is to evaluate the correlation of inflammatory markers in COVID-19 positive patients among various age groups. The study was done on 225 COVID-19 patients, admitted to Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh India, between 1st April-15th June 2021 categorizing into two groups based on their age (≤45 years and >45 years) and then values of various markers were gathered and compared. Among the 225 admitted COVID-19 patients, 78(34.6%) were ≤45 years, while the remaining 147(65.4%) were >45 years. Between these two age groups the aberrant values of inflammatory makers like Neutrophil count (p=0.0001), Lymphocyte count (p=0.0001), Neutrophil to Lymphocyte Ratio (NLR) (p=0.0091), Serum CRP level (p=0.0437), Lymphocyte to C-reactive protein ratio (LCR) (p=0.0007) as well as Serum Ferritin level (p=0.0097) were found to be statistically significant whereas the remaining parameters like Total leucocyte count (TLC) (p=0.0905), Platelet count (p=0.8202) and Platelet to lymphocyte ratio (PLR) (p=0.1513) were statistically insignificant. The results conclude that there was a significant correlation between the age and the inflammatory markers in these patients. Patients with > 45 years had elevated/deranged levels of inflammatory markers, which were associated with the severity and poor prognosis of the disease. Thus, age can be considered as one of the important key risk factor for the severity of COVID-19 in both sexes and hence more clinical attention should be given to elderly age group.
BACKGROUND Gallbladder is an important organ of the body, where the storage and concentration of bile takes place. More than 95% of the biliary tract disease is attributed to cholelithiasis (gall stones). The gall bladder pathology ranges from cholecystitis to highly lethal carcinoma. The present study was conducted to review the significant histopathological findings encountered in gallbladder specimens received in our institute. MATERIALS AND METHODS In this retrospective descriptive study, one hundred and twenty (120) cholecystectomy specimens were studied over a period of two years (January 2015 to December 2016).
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