Laparoscopic repair of a large duodenal perforation secondary to an indwelling nasogastric tube in a tracheotomized adult.

Laparoscopic repair of perforated duodenal ulcers is safe and effective in centers with experience and increasingly performed by laparoscopic surgeons. However, the role of laparoscopy for the management of large duodenal perforations (>1 cm) is unclear. To date, no experience has been reported with emergency laparoscopic repair of large perforations for gastroduodenal ulcers.

Gas-less Video-assisted Thyroidectomy for a Solitary Thyroid Nodule: Technical Report of the First Case Performed at a Rural Teaching Hospital in India and Review of Literature.

Minimally invasive thyroidectomy is still in its phase of evolution with various techniques being practiced only in certain centers internationally. The conventional thyroidectomy performed by the Kocher's cervicotomy often leaves an undesirable scar over the neck, the size of which is usually around 8-10 cm long. The main aim of minimally invasive thyroid surgery is to minimize or avoid the scar over the neck.

Epidural anesthesia and post-operative analgesia for bilateral inguinal mesh hernioplasty: Comparison of equipotent doses of ropivacaine and bupivacaine.

Objectives: Ropivacaine is a long-acting amide local anesthetic, which is structurally very similar to bupivacaine but produces less motor block and less cardiac and central nervous system toxicity. It is also about 40% less potent than bupivacaine. Our double blind study was designed to compare the clinical efficacy of the equipotent doses of ropivacaine 0.

A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section.

Neuraxial opioids provide excellent analgesia intraoperatively and postoperatively while allowing early ambulation of the patient by sparing sympathetic and motor nerves. A prospective, randomised double blind study was conducted involving 90 patients of ASA 1 physical status coming for elective cesarean section to evaluate the analgesic effect of neuraxial buprenorphine. They were allocated into three groups.

Reverse Transrectal Stapling Technique Using the EEA Stapler: An Alternative Approach in Difficult Reversal of Hartmann's Procedure.

The introduction of circular end-to-end stapling devices (CEEA OR EEA stapler) into colorectal surgery have revolutionised anastomotic techniques. The EEA stapler is generally regarded as an instrument that is safe, reliable, and simple to operate. Despite it's popularity, very little information is available regarding the technical difficulties encountered during surgery.

Synchronous Perforation of the Ileum and Meckel's Diverticulum Due to Tuberculosis.

Perforation of the Meckel's diverticulum due to tuberculosis is a rare phenomenon. A 45 years old male who presented with perforation peritonitis was found to have a synchronous dual perforation involving the ileum and the Meckel's diverticulum, due to intestinal tuberculosis. In addition to this, the Meckel's diverticulum was found to have a daughter diverticulum (diverticulum within diverticulum), which was probably pulsion or traction diverticulum as it did not have all layers of the intestinal wall.

Incarcerated Gastro-thorax: a rare and delayed presentation of diaphragmatic injury due to multiple stab wounds.

Diaphragmatic injuries due to thoraco-abdominal penetrating trauma may often go unnoticed at the initial admission, especially in patients who are asymptomatic, with stable hemodynamic and respiratory parameters. Such occult diaphragmatic perforations can result in latent morbidity and mortality due to delayed trans-diaphragmatic herniation of the abdominal viscera leading to incarceration, strangulation and perforation. Here we report a case of an initially asymptomatic patient who had sustained multiple truncal stab injuries and presented two months later with a trans-thoracic incarceration of the stomach which was accurately diagnosed and successfully repaired at the time of surgery.

Traumatic dislocations of the proximal tibiofibular joint: a report of two cases.

Traumatic dislocations of the proximal tibiofibular joint are rare and difficult to diagnose. They can present as an isolated case or in association with multiple injuries. They are typically classified into subluxation, anterolateral, posteromedial, and superior dislocations.

Retrospective study of severe cases of leptospirosis admitted in the intensive care unit.

Objectives: Evaluate patient demographics, risk factors, complications, seropositivity, treatment and outcome among leptospirosis patients.

Design: Retrospective analysis of 104 patients admitted in the intensive care unit (ICU) with a clinical suspicion of leptopirosis.

Setting: Ten-bedded medical ICU in a medical school situated in a rural area endemic for leptospirosis.

Multiplex PCR on leptospiral isolates from Kolenchery, Kerala, India.

Human leptospirosis causes severe multiorgan dysfunctions that may end in multiorgan failure and death. The methods in hand for diagnosis of leptospirosis like culture, ELISA and MAT only help to confirm the disease, and are of little value in early detection. The aim of this study was to find out if the two sets of primers described earlier could detect all the isolates from the area, for the purpose of using the resultant database for early detection of leptospires in future from clinical specimens.