SummaryA new site for the adjustable pressure limiting valve has been suggested which will result in the most efficient utilisation of soda lime using typicaljows with a circle absorber system. It will permit economy offresh gases using oldmodels of circle absorbers in which the adjustable pressure limiting valve andfresh gas inlet are both situated upstream of the inspiratory unidirectional valve. The cost of the new attachment is small
The aim of this study was to compare the outcomes of surgical versus non-surgical treatment in the management of Diabetic Foot Ulcer. A Prospective Observational Study which was carried out in the Department of Surgery of Rajah Muthiah Medical College Hospital a tertiary health care hospital in Chidambaram, Cuddalore District, Tamilnadu in the period of November 2016 to April, 2017 (6 months). The patient demographic, disease, ulcer size, drugs and treatment prescribed were collected in a specially designed data collection form which also included bacterial culture tests. Upon enrolment for the study 65% (39) of the patients diagnosed for diabetic foot were male and 35% (21) were female. The demographic classification suggests that diabetic foot incidence has increased upon ages of people ranging between the mean ages of 45+/-5 years to 60+/-5 years. The bacterial distribution over the patients showed that, out of which Escherichia coli (28.3%) and Staphylococcus aureus (15%) are the most common bacteria. The outcomes mainly depend upon the grading of infection and ulcer size. The superficial ulcers can be treated more effectively with antibiotics and regular dressings, whereas the deep ulcers and gangrene should be intervened with surgical procedures. The assessed study reports that clinical pharmacist intervention by patient education and medication counselling creates a significant influence in medication adherence
Methods: An infant with right isomerism, single ventricle, left sided SVC and an anomalous pulmonary vein to the SVC presented with cyanosis. During surgery, the SVC was transected above the opening of the anomalous pulmonary vein and fully mobilized of all its tributaries leaving the anomalous drainage intact. The MPA was transected and the branch pulmonary arteries mobilized. This enabled us to perform the anastomosis between SVC and LPA without any kink or tension.Results: The patient made an uneventful recovery and postoperative echocardiography showed a functioning BCPS with good pulmonary flow. The patient is on follow up with a saturation of 90 on 3 month follow up Conclusions: The technique adopted by us ensured approximation of SVC anJ LPA to perform a tension free BCPS. It does not involve a suture line in the artium that may need future revisions. This can displace the pulmonmy arteries upwards and can make the completion by lateral tunnel Fontan difficult. However, most of these cases undergo subequent completion by extra cardiac Fontan for fear of pulmonary vein obstruction by the intracardiac baffle.
Introduction:In the past few decades, rates of cardio vascular Disease (CVD) have increased from 4 to 11% in the Indian population. Gene polymorphisms play an important role in causing disease. A number of candidate genes have been associated with CVD. Studies suggest an association of CVD and polymorphisms with Angiotensinconverting enzyme (ACE). Angiotensin I is converted to a vasoconstrictor angiotensin II by ACE. Increase in angiotensin II can lead to the increase in blood pressure, inducing various cardiovascular problems. Increased ACE levels have been shown to be associated with D-allele.Methods: We analyzed 73 cases referred to the department of cardiothoracic surgery for cardiac surgery. The cases were categorized as coronary artery disease (CAD) (n=39), congenital heart disease-(CHD) (n=20), rheumatic heart disease (RHD) (n=14). 2 ml heparinised blood was collected prior to surgery. DNA was isolated and PCR for ACE genotype carried out using specific primers. The products were then run on 2 % agarose gel to identify the insertion (490 bp), insertion / deletion (490/190 bp) and deletion (190 bp) polymorphisms.Results: 74.3% CAD cases, 60% CHD cases and 57.1% of RHD cases showed the D-allele. These were compared with control group and our results showed that there was significant increase in the Dallele in CAD group with 'p' value < 0.05.
Conclusions:Our results indicate that ACE gene D allele is playing a role in the development of CAD and knowing the genotype of the patient will help manage the patient appropriately.Background: Over a period of 27 years, 71 cases of cardiac tumors were operated upon in the departmcnt of cardiothoracic surgery, at the Postgraduate Institute of Medical Education and Research, Chandigarh. We summarize our expericnce with cardiac tumors.Methods: The diagnosis was established by echo cardiography, angiocardiography and computed tomography. In one case the diagnosis was made at autopsy. All myxomas, were removed completely through right atrial or biatrial approach with the use of cardiopulmonary bypass. Thc resulting interatrial defects were closed directly or with a patch.Results: These included 63 (88.7%) patients with benign tumors and 9 (12.7%) patients with primary malignant tumors. All the benign tumors were myxomas, of which 52 (83.9%,) were in the left atrium, 7 (10.8%) in right atrium and 3 (4.8%) were biatrial. There were no familial cases. Thromboembolism was observed in 7 cases. Primary malignant tumors comprised 2 rhabdomyosarcomas, 3 angiosarcomas, I lymphoma and 3 cases of malignant fibrous histiocytoma Four cases of primary malignant tumors were nonresectable. In 2 cases extensive resection and patch reconstruction of the the right atrial wall was required. Mitral valve invadede by the stalk of the myxomas was preserved in 2 cases. Near total resection of a malignant fibrous histiocytoma arising from the right middle pulmonary vein and left atrial junction was achieved. There were 3 operative deaths (4.2 %) and I recurrence (1.4%) in the benign group.Conclusio...
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