Spigelian hernias are rare hernias, representing only about 1-2% of all abdominal hernias. An accurate preoperative diagnosis of this condition is often difficult because the physical presence of these hernias is often not demonstrable owing to its peculiar anatomic location. Many patients with Spigelian hernias, therefore, may have no obvious findings on clinical examination. The diagnosis is even trickier in obese patients wherein the hernia sac may lie in an intraparietal plane, masked by the abdominal subcutaneous fat. Here we describe a case of incarcerated Spigelian hernia where clinical and radiological findings were inconsistent and the accurate diagnosis was made by laparoscopy and was followed by a laparoscopic-assisted repair using an open anterior approach with an onlay mesh. We therefore feel that laparoscopy can be a useful tool for confirming the diagnosis and also for performing a definitive repair in doubtful cases of Spigelian hernias.
Background: A split-mouth longitudinal study was conducted to compare and evaluate the effect of ozonated water and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis, along with mechanical debridement procedure. Materials and Methods: Twenty-two patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. Upper right and left quadrants of each patient were considered as sample sites in the study. Among these split-mouth sites, upper right quadrant of each patient was subjected to ozonated water irrigation with a 22-gauge needle and left upper quadrant was treated with PDT, which involved sulcus irrigation with indocyanine green dye (0.05 mg/ml) followed by low-level diode laser light application at 0.5 W and 810 nm (AMD Picasso) through a fiber-optic tip of 10 mm length, default angle of 60°, and fiber core diameter of 400 μm in noncontact continuous wave mode. Patients were recalled at the 2 nd and 4 th months regularly, and the therapy was repeated at the same sites in the same manner. Clinical parameters recorded before the study were assessed again at the end of the 2 nd - and 6 th -month period. Results: A statistically significant reduction ( P < 0.05) was observed in gingival index scores within both the study groups at all intervals of the study. In Ozone therapy (OT) group, a statistically significant difference was noted for total periodontal pocket depth values between baseline and 2 nd month ( P = 0.000), baseline and 6 th month ( P = 0.000), and between 2 nd month and 6 th month ( P = 0.029). In the PDT group, on contrary, a statistically significant difference was noticed in total periodontal pocket probing depth values between baseline and 2 nd month ( P = 0.000) and baseline to 6 th month ( P = 0.000), but a similar significant difference was not noticed between 2 nd -month and 6 th -month periods ( P = 0.269). In group OT, a statistically significant difference was noted for total clinical attachment loss between baseline and 2 nd month ( P = 0.000), baseline and 6 months ( P = 0.000), and 2 nd month and 6 th month ( P = 0.019). In group PDT, a stat...
Introduction:The Severe Acute Respiratory Syndrome Coronavirus 2(SARS CoV2), started in Wuhan in China at December 2019.The symptoms mainly included fatigue, fever, dry and productive cough, shortness of breath, chest compression, myalgia, diarrhea, vomiting, anorexia, headache, sore throat, dizziness, palpitations, and, chest pain. Anosmia and/or ageusia may present as a symptom alone in cases of COVID-19. Hence it is necessary to test or quarantine patients with these complaints. Aims and objectives:To determine the prevalence of anosmia and ageusia in patients with COVID-19 presenting to our tertiary care center. Materials and Methods:All patients with confirmed real time polymerase chain reaction (RT-PCR) positive testing for the SARS -CoV-2 viral genome was assessed for symptoms and signs of olfactory and taste disturbance.Patients were asked to quantify their loss of sense of smell and taste, subjectively into mild, moderate and severe.Results: Out of 2000 patients 95 patients (4.75%) had loss of sense of smell, and 143 patients (7.15%) had taste disturbance. 85 patients (4.25%) had both loss of smell and taste sensation. Out of 95 patients with loss of smell sensation, 25 patients (26.31%) had associated comorbidities, 32 patients (22.37%) out of the 143 with loss of taste sensation had comorbidities and 19(22.35%) patients out of the 110 patients with loss of both sensations had associated comorbidities.Out of 95 patients with loss of smell sensation, 72 (75.78%) patients recovered spontaneously. Out of 143 patients with loss of taste, 102 (79.44) patients recovered spontaneously. Among the patients with both symptoms, 59 (69.41%) recovered spontaneously. Conclusion: Loss of smell and taste sensation is common, especially in COVID-19 disease with mild to moderate symptoms, and it can appear without any other general and ENT-related symptoms associated with COVID-19 disease or it may be the only symptom of COVID-19 disease. During the COVID-19 pandemic, screening tests performed in patients with loss of taste and smell sensation due to suspected COVID-19 disease will allow early diagnosis and treatment of patients.
Influenza virus primarily affects ciliated cells of respiratory epithelium. Humans do not have innate immunity for these viruses and are vulnerable to get attacked. Benign acute childhood myositis usually occurs at the early convalescent phase of a influenza viral illness when fever, cough, myalgia, nasal discharge are the initial presentation.
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