Radical sternectomy for osteomyelitis without reconstruction post-coronary artery bypass graft: 10 years on.

Radical sternectomy with sternal reconstruction using synthetic mesh or titanium plates has been described before with excellent results. However, radical removal of the sternum without reconstruction is a rare surgical treatment for complicated deep sternal wound infections (DSWI). The long-term outcome following this radical operation is not well-known due to the limited number of cases in the literature.

Analysis of the Performance of Daily Cardiac Surgery Score (CASUS) in Patients with Mixed Racial Profile after Cardiac Surgery: A Single-Center Retrospective Study.

Objective: The aim was to look at the Cardiac Surgery Score (CASUS) assessment after cardiac surgery, and compare it with the intensive care unit (ICU) mortality and morbidity, in a racially diverse group of patients, in a single center.

Design: Clinical retrospective study analyzing data from 319 patients over a 1-year duration.

Setting: Cardiothoracic intensive care unit (CTICU) of a tertiary care center.

Successful Surgical Embolectomy for a Rapidly Deteriorating Patient with Pulmonary Embolism and Hemorrhagic Stroke.

Pulmonary embolism (PE) is a life-threatening condition. High-risk PE is defined as pulmonary embolism with either hemodynamic collapse, persistent hypotension, and/or organ hypoperfusion. The overall mortality rate associated with high-risk PE remains at approximately 30%.

Efficacy and safety of beating heart mitral valve replacement.

Background: The interest in beating heart surgery is growing since better results can be obtained with this procedure compared to conventional myocardial protection techniques using cardioplegic solutions. This led us to consider mitral valve replacement with beating heart.

Objectives: This study aimed to determine the safety and efficacy of beating heart mitral valve replacement without cross clamp.

Outcome of trans-axillary approach for surgical decompression of thoracic outlet: a retrospective study in a tertiary care hospital.

Objective: The aim of this study was to evaluate the trans-axillary surgical approach in patients with thoracic outlet syndrome.

Methods: This retrospective study is comprised of data acquired from January 1998 until Oct 2008. Case histories of all the patients were reviewed from the Medical Records Department of Sher-i-Kashmir Institute.

Evaluating peripheral vascular injuries: is color Doppler enough for diagnosis?

Background: Vascular injury poses a serious threat to limb and life. Thus, diagnosis should be made immediately with minimally invasive methods. Doppler is a good aid in diagnosis of vascular injury.

Comparing Aortic Valve Replacement through Right Anterolateral Thoracotomy with Median Sternotomy.

Background: Aortic Valve Replacement (AVR) is usually done through median sternotomy. The present study aimed to compare the right anterolateral thoracotomy and median sternotomy approaches for AVR.

Materials And Methods: The present prospective study was conducted on 60 patients who had aortic valve disease and were subjected to AVR.

Native arterio-venous fistula is the vascular access of choice for hemodialysis in end stage renal disease.

Objectives: THE AIM OF THE STUDY WAS: Is primary Arterio-venous fistula the vascular access of choice for adequate dialysis and better patient outcome in end stage renal disease.

Materials And Methods: The present study was done in the department of cardiovascular and thoracic surgery at Sher-i-Kashmir institute of medical sciences, Soura, Srinagar Kashmir. Native Arterio-Venous (AV) fistulas were made in the patients with end stage renal disease for performing hemodialysis.

Comparison of right anterolateral thorocotomy with standard median steronotomy for mitral valve replacement.

Obejectives: The objectives of this study were to compare and analyze the results of right anterolateral thoracotomy and median sternotomy approach for primary mitral valve replacement with reference to the exposure during Valve Replacement , length of surgical incision, mean cross clamp time, mean bypass time, intensive care unit (ICU) stay, hospitalization, overall comorbidity with sternotomy; sepsis, dehiscence, healing cosmetic issues and cost effectiveness.

Methods: The present study comprised 68 patients with rheumatic mitral valve disease who underwent mitral valve replacement in the Department ofCardiovascular and Thoracic Surgery at Sher‑i‑Kashmir Institute of Medical Sciences from September 2009 to August 2011.

Results: This study comprised 64 patients with 23 (35.

Gastric cancer in young patients.

Aim: The aim of this study was to see the clinical, pathological, and demographic profile of young patients with stomach carcinoma besides association with p53.

Patients And Methods: Prospective study of young patients with stomach carcinoma from January 2005 to December 2009. A total of 50 patients with age less than 40 years were studied.

The Efficacy of Rigid Bronchoscopy for Foreign Body Aspiration.

The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our  population.  This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid bronchoscopy under local or general anesthesia.

Delayed presentation of traumatic diaphragmatic hernia: a diagnosis of suspicion with increased morbidity and mortality.

Background: Diaphragmatic rupture due to blunt or penetrating injury may be a missed diagnosis in an acute setting and can present with a delayed complication with significantly increased morbidity and mortality.

Objectives: The objective of this study is to better understand why diaphragmatic tears with delayed presentation and diagnosis are so often missed and why traumatic diaphragmatic tears are difficult to diagnose in emergency settings and how they present with grievous complications.

Patients And Methods: Eleven patients with diaphragmatic hernias with delayed presentation and delayed diagnosis were operated within the last five years.

The diagnostic efficacy of adenosine deaminase in tubercular effusion.

Objective: This study aims to evaluate the diagnostic efficacy of adenosine deaminase in tubercular effusions.

Methods: This study was conducted at the Department of General Medicine and Cardiovascular and Thoracic Surgery, SKIMS, for a period of two years between November 2008 and November 2010. A total of 57 patients presenting with pleural effusions during the two-year study period, who presented with clinical manifestations suggestive of tuberculosis (i.

The Pattern, Presentation and Management of Pardah Pin Inhalation: Report from a Single Center in Northern India.

Objective: To describe the clinical characteristics, presentation and management of Pardah pin inhalation in female teenagers of single center in northern India.

Methods: This was a prospective cross-sectional study being performed in department of cardiovascular and thoracic surgery of Sher-i-Kashmir institute of medical sciences located in northern India from January 2009 to December 2012. We included 36 female patients with Pardah pin inhalation who were admitted to our center during the study period.

Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy.

Background: The aim of this study was to see the efficacy of endorectal coil MRI and MR spectroscopic imaging in patients with elevated serum PSA and negative transrectal ultrasonography (TRUS)-guided biopsy.

Materials And Methods: This study was conducted on 87 patients presented with: • Elevated prostatic specific antigen levels >5 ng/ml • Symptoms and signs of prostatic carcinoma • Patients with negative TRUS-guided biopsy • Suspicious lesion on TRU. All the patients were subjected to TRUS and followed by TRUS-guided biopsy of the lesion identified on endorectal coil MRI and MR-Spectroscopy.

Esophageal Tuberculosis Presenting As Dysphagia.

Esophageal tuberculosis is rare in both immunocompromised and immunocompetent hosts with advanced pulmonary tuberculosis, even in countries with high prevalence of tuberculosis, e.g., South East Asia.

Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course.

Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia.

The increasing rate of secondary amputation in popliteal arterial injury associated with multi-organ injuries and hypotension.

Obejectives: To study the role of hypotension and associated injuries in increasing the chances of secondary amputation in lower limb with vascular injuries.

Methods: This study was conducted in the Department of cardiovascular and thoracic surgery( CVTS ), Sher-i- Kashmir Institute of Medical Sciences, ( SKIMS ) Srinagar Kashmir India and comprised all patients sustaining vascular injury due to different causes like road traffic accident, fire arm and blast injuries or falling from height during the last five years. Following admission to our Department, the patients were divided into two groups.

Peripheral vascular injuries due to blunt trauma (road traffic accident): management and outcome.

Background: The present study was undertaken to analyze the pattern, presentation and management of peripheral vascular injuries due to road traffic accidents (RTA).

Methods: A prospective study of patients of peripheral vascular injuries due to road traffic accidents (RTA) between Jan. 2007 to Dec.

Does circumcision alter the periurethral uropathogenic bacterial flora.

Background: The aim of this study was to assess the pattern of periurethral bacterial flora in uncircumcised boys and to evaluate the effect of circumcision on alteration of periurethral uropathogenic bacterial flora.

Materials And Methods: Pattern of periurethral bacterial flora before and after circumcision was studied prospectively in 124 boys. The results were analysed to compare change in bacterial colonisation before and after circumcision.

Cancer in Kashmir, India: burden and pattern of disease.

Background: Incidence and prevalence of cancers differ in different regions of the world. To study the profile of different cancers in a particular cancer belt helps to know the exact incidence of different cancers in that region and their likely etiology. The aim of this study was to analyze the incidence of different cancers in Kashmir valley.

Role of liberal primary fasciotomy in traumatic vascular injury.

Background: Vascular injury represents less than 1% of all injuries, but deserves special attention because of its severe complications. Amputation or retention of a painful functionless limb is the most untoward result of severe vascular injury or inadequate treatmet. Thus, vascular injury needs a judicious and multidimensional approach.

Vascular injuries: trends in management.

Vascular injury presents a great challenge to the emergency resident because these injuries require urgent intervention to prevent loss of life or limb. Sometimes serious vascular injury presents with only subtle or occult signs or symptoms. The patient may present weeks or months after initial injury with symptoms of vascular insufficiency, embolization, pseudoaneurysm, arteriovenous fistula etc.