Background: Fixed flexion deformity is a common accompaniment in advanced arthritis of the knee joint. Complete correction of fixed flexion deformity at the time of surgery remains challenging and technically demanding.Objectives: The purpose of our study was to assess the result of total knee replacement using a preset algorithm to assess the effect that a preoperative flexion deformity has on postoperative correction.Materials & Methods: This retrospective study reviewed severe flexion contracture of patients who underwent primary TKA and soft tissue balancing from June 2010 to July 2016. The data included preoperative, intraoperative, and postoperative evaluation at standard intervals and annual follow-up reports.Results: There were no intraoperative complications in this study. The average flexion contractures and ROM were not different between SF and MF groups (1.14 ± 0.27 vs. 1.12 ± 0.35 and 115.72 ± 15.13 vs. 118.34 ± 12.68).Conclusion: TKA can be performed successfully in knees with severe flexion contracture.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 2-7
Background: Total thyroidectomy is commonly practice now-a-days for either malignant or benign multinodular goitre. And post-operative hypocalcaemia is a squeal in this operation.Objectives: To find out whether post-operative PTH level is a parameter to identify hypocalcaemia after total thyroidectomy.Materials & Methods: This study was carried out from July 2013 to July 2014 in department of Surgery Sir Salimullah Medical College & Mitford Hospital. Total 116 patients were selected. PTH assay was performed before and after thyroidectomy. 92 patients were undergoing total thyroidectomy and were selected as test group. Rest 24 patients were undergoing unilateral lobectomy and were selected as control group. Serum calcium levels were measured in 1st and 2nd post-operative day.Results: Out of 92 test group patients 31(26.7%) developed postoperative hypocalcemia. Hypocalcemic patients had significantly lower post-operative PTH 5.43 ± 5.32 (median 3.3) compared with that of normocalcemic patient 16.04 ± 11.96 (median 12.5). Serum calcium was significantly lower in hypocalcemic patients at 2nd post-operative day (median 9.8) than in 1st post-operative day (median 10.15). Linear regression curve estimation revealed significant association between post-operative PTH with 2nd post-operative serum calcium.Conclusion: PTH assay can identify patients at risk of clinically significant hypocalcemia much earlier than serum calcium monitoring. A single PTH level post-operatively can reflect early result and help to take necessary measure to avoid hypocalcaemic effect.KYAMC Journal Vol. 9, No.-2, July 2018, Page 43-47
A gastrointestinal (GI) fistula is an abnormal connection between gut (GI tract) and an epithelialized surface of skin or another hollow organ or another part of gut. These GI fistulas can cause profound GI bleeding, which may need emergency surgery. Other complications include Malnutrion, Undernutrion, Anaemias, Fluid, and Electrlyte imbalances, Hypovolemic shock, Septic shock, Pyaemic abscesses, Kidney malfunction and failure, Cardiac dysrhythmias, and failure, Hepatitis, Cerebral dysfynction and strokes, DIC etc if neglected, maltreated or untreated. Most GI fistulas occur as a complication of abdominal surgery. However, some fistulas evolve spontaneously and are usually the result of intra-abdominal inflammation or infection. Several classification systems for GI fistulas exist, none of which are used exclusively. The most commonly used classification systems are based on anatomic, physiologic (output volume), and etiologic characteristics. Used in combination, these classifications can help to provide an integrated understanding and optimal management scheme for the fistula. History taking, Physical examination, Endoscopy, Imaging studies and other laboratory tests are variably required for total assessment, evaluation, and concrete diagnosis. Intensive medical, and surgical therapies are now quite dramatically helpful to reduce the morbidity and mortality. This treatise on GI fistula is here to update the information about the latest developments of GI fistula.KYAMC Journal Vol. 9, No.-2, July 2018, Page 87-94
There are many well-known causes of acute or sub-acute intestinal obstruction. But Pneumatosis cystoides intestinalis (PCI) is a rare cause and can easily be misdiagnosed. PCI refers to presence of air within the wall of small or large intestine. This benign disease having both idiopathic and secondary causes with different contributing pathogenic factors that confuses many doctors. In most of the time it is asymptomatic, but clinical signs and imaging impressions may mimic true abdominal visceral perforation or soft tissue stranding leads to mechanical obstruction. PCI is sometimes incidentally found during radiological evaluation, endoscopic procedure or laparotomy. Surgery is not recommended for PCI if there was no intestinal obstruction, because of high operative risk. So correct diagnosis is imperative as treatment of PCI is generally conservative. We are presenting a case of intestinal obstruction who underwent to laparotomy followed by the histopathological diagnosis as a case of PCI. KYAMC Journal Vol. 13, No. 03, October 2022: 177-180
Adult intussusception is a rare disease, found 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction. In adults, intussusception is typically due to a pathologic lead point within the bowel, which is malignant in over 50% of cases. Inflammatory fibroid polyp (also known as Vanek' stumour) is an uncommon, non-neoplastic proliferating lesion which can develop in various parts of the gastro-intestinal tract but most commonly in the gastric antrum and the ileum. Here we present a case of 35 years old lady with symptoms intermittent lower abdominal pain. USG of abdomen revealed as right adnexal complex cyst with thicken gut wall. She was underwent laparotomy and found ileo-ileal intussusception but no adnexal pathology. Segmental resection done where histopathology reported as loops of intussusception containing inflammatory fibroid polyp. KYAMC Journal Vol. 9, No.-4, January 2019, Page 190-193
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