Background: Chest trauma is a commonly encountered surgical emergency, constitutes about 10% of the

Experience in 111 patients treated for extremity vascular trauma between 1995 and 2004 is described. Only 40 (36%) patients presented within 6 hours of sustaining the injury. Penetrating injuries due to stabbing and gunshots were the causes in 65 patients, and blunt trauma in 46. There were associated bone fractures in 73 patients. The brachial artery was the most commonly injured upper limb vessel, whereas the femoral vessels were most often damaged in the lower limb. Surgical procedures consisted of end-to-end anastomosis in 50 patients, an interposition graft in 32, lateral arteriorrhaphy in 14, ligation in 6 and venous patch plasty in 5. Concomitant artery and vein repair was carried out in 12 patients, 6 underwent embolectomy and fasciotomy was performed in 16. Three (2.7%) patients died postoperatively. Good blood flow was obtained after repair in 69 (62%) patients, 29 (26%) had collateral compensation, 5 underwent primary amputation and 5 required secondary amputation. Most vascular injuries due to limb trauma can be managed successfully unless associated with severe damage to bones, nerves or soft tissues.

purpose. To evaluate the outcome of single screwrod anterior instrumentation for thoracolumbar burst fractures with incomplete neurological deficit. Methods. 16 men and 5 women aged 22 to 55 (mean, 34) years underwent single screw-rod anterior instrumentation for thoracolumbar burst fractures with incomplete neurological deficit. The vertebrae involved were T10 (n=2), T11 (n=2), T12 (n=7), L1 (n=8), and L2 (n=2). No patient had disruption of the posterior ligament complex. Postoperatively, a thoracolumbar sacral orthosis was used until solid fusion. Outcome measures included neurological recovery, degree of kyphosis, complications, and pain and functional status of the patients. results. The mean follow-up duration was 36 (range, 13-50) months. All patients recovered neurologically by at least one grade. Of the 21 patients, 6 improved from grade B to grade C (n=4) or grade D (n=2), 13 from grade C to grade D, and 2 from grade D to grade E. The mean degree of kyphosis improved from

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Aims:To study the effect of Cilostazole and Pentoxifylline on claudication distance and lipid profile in patients with occlusive peripheral arterial disease.Methods: A total of 79 patients having clinically and or angiographically proven occlusive peripheral arterial disease who attended outdoor patient at department of Cardio-Thoracic and Vascular Surgery (CTVS), Govt. Medical College, Jammu were included in blind, randomized, placebo controlled trial. Group I Patients (n=26) were administered Tab. Pentoxifylline 400 mg thrice a day; Group II (n=28), Tab Cilostazol 100 mg twice a day and Group III (n=25) were administered Tab B Complex twice a day as a placebo. All the patients in different groups were followed for one year. History, clinical examination, all routine investigation including lipid profile, color doppler study of lower limb and Angiography of lower limb vessels was performed at the start of the trial. Patients were re-evaluated every 2 weeks, 4 weeks, 6 weeks, 10 weeks and 12 weeks for Intermittent Claudication Distance (ICD), Absolute Claudication Distance (ACD), lipid profile and side effects. Results: The group II (Cilostazole Group) showed more rise in ICD and ACD as compared to Pentoxifylline and Placebo groups. There was a statistically significant decline of Triglyceride and Low Density Lipid (LDL) levels in Group II (Cilostazole Group) as compared to Group I (Pentoxifylline) and Group III (Placebo Group). No statistically significant difference was observed between the three groups on commonly observed adverse effectsConclusions: Thus, the comparative analysis revealed that the efficacy of Cilostazole is more than the Pentoxifylline and Placebo in increasing the ICD and ACD in patients of occlusive peripheral arterial disease. In addition, Cilostazole also lowers Triglyceride and LDL levels and increases High Density Lipid (HDL) levels which was not observed with Pentoxifylline and Placebo. (Ind J Thorac Cardiovasc Surg 2009; 25: 45-48)