Hemi-Fibular Grafting for Metacarpal Giant Cell Tumor - Surgical Technique.

Introduction: Giant cell tumor (GCT) of small bones of hand is no so uncommon, especially in the metacarpals. Considering the aggressive behavior in the metacarpals, en bloc resection is often required. Following resection, reconstruction techniques available include tricortical iliac grafting, vascularized or non-vascularized fibular grafting, or metatarsal grafting.

Regional leptomeningeal collateral score by computed tomographic angiography correlates with 3-month clinical outcome in acute ischemic stroke.

Purpose: The aim of the study is to assess the correlation between regional leptomeningeal collateral (rLMC) Scores calculated on computed tomography (CT) angiography following acute anterior circulation ischemic stroke, with 3-month clinical outcome measured as modified Rankin Scale (mRS) and Barthel Index (BI).

Materials And Methods: A total of thirty patients were studied as per the exclusion and inclusion criteria and after informed consent. Multi-phase CT angiography was carried out within 24 h of stroke onset, and collateral scoring was done using rLMC score along with Alberta stroke programme early CT (ASPECT) scoring.

Challenges faced in the management of complicated Boerhaave syndrome: a tertiary care center experience.

Spontaneous esophageal perforation is rare and is associated with high morbidity and mortality. A spectrum of various surgical modalities ranging from primary surgical repair to esophagectomy is available for its management. The optimal management of patients presenting late in a hemodynamically stable condition is not clearly defined in the literature.

Risk-benefit analysis of wound drain usage in spine surgery: a systematic review and meta-analysis with evidence summary.

Study Design: Systematic review, meta-analysis, evidence synthesis.

Objectives: To analyse the literature evidence available to support the usage of wound drain in various scenarios of spine surgery and provide an evidence summary on the surgical practice.

Materials And Methods: We conducted independent and duplicate electronic database searches adhering to PRISMA guidelines in PubMed, Embase, and Cochrane Library till April 2020.

Noniatrogenic Colorectal Barotrauma with Extraperitoneal Rectal Injury.

We present the case of a 22-year-old male who presented to us with abdomen discomfort with subcutaneous emphysema in the abdomen and lower chest, following a prank played by his friend who had inserted a nozzle through his anal orifice and pumped high-pressure condensed air through it. Computed tomography showed evidence of air pockets in the ischiorectal fossa and pelvis. Intraoperatively, we found large-bowel and small-bowel distension with large-bowel serosal tears and rectal tears.

Hansen's disease with lepra reaction presenting with IgA dominant infection related glomerulonephritis.

Various renal abnormalities in leprosy have been described largely in literature but the occurrence of IgA dominant infection related glomerulonephritis in leprosy with type 2 lepra reaction has not been reported so far. We present here a 60-year-old man with a history of leprosy in the past admitted with type 2 lepra reaction, rapidly progressive glomerulonephritis with severe renal failure requiring dialysis and diagnosed to have IgA dominant infection related glomerulonephritis.

Clinical Experience on Hearing Screening in Twins and Triplets: A Retrospective Study.

Twin or multiple pregnancies often have neonatal complications. Common complications include low birth weight, respiratory distress, neonatal intensive care unit (NICU) admission (>5 days) and low APGAR score especially on second twin. (1) To compare referral rates of newborn hearing screening in twins and triplets between risk and non-risk babies for hearing loss, (2) to determine the effects of birth order on referral rates in twins and triplets.

Surgical Management of Unruptured Cerebral Aneurysms in the Elderly: An Institution Experience.

Background And Purpose: The elderly population is increasing in the world, especially in developed countries. The gain in life expectancy is remarkable in Japan, consequently incidence of aneurysms increases in this population. The purpose of this study is to evaluate the surgical treatment and outcome of patients aged more than 75 years treated for unruptured intracranial aneurysms.

Superficial Temporal Artery: Middle Cerebral Artery Bypass, Our Series of 20 Cases, Surgical Technique and Indications with Illustrative Cases.

The first extracranial-intracranial (EC-IC) bypass surgery was performed by professor Yasargil in 1967 since then this procedure has been widely used in vascular neurosurgery and sometimes, in tumors excision when a vascular sacrifice is necessary. In this article, we will illustrate the surgical technique of the superficial temporal artery-middle cerebral artery (STA-MCA) bypass with two cases; a 59-year-old male and 64-year-old female who presented with an occlusion of the MCA. The male presented also with a posterior communicating artery-IC aneurysm which was clipped in the same sitting.

Proliferative Glomerulonephritis with Monoclonal IgG Deposits.

Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a recently described disorder that belongs to the class of monoclonal gammopathy of renal significance with the incidence of 0.17%. Monoclonal IgG deposits in glomeruli can produce a proliferative glomerulonephritis that mimics immune-complex mediated glomerulonephritis by light microscopy (LM) and electron microscopy (EM).

Systemic Lupus Erythematosus and Myasthenia Gravis: A Rare Association.

Systemic lupus erythematosus (SLE) and myasthenia gravis (MG) are two autoimmune diseases that have a higher incidence in young females, relapsing-remitting course, and positive antinuclear antibodies. SLE and MG are two different clinical syndromes, which can coexist or precede each other; however, their occurrence in the same patient is rare. We report a 38-year-old female with biopsy-proven lupus nephritis on steroids and cyclophosphamide, later developed MG.

A Prospective Study on the Diagnostic Value of Hyperbilirubinemia as a Predictive Factor for Appendicular Perforation in Acute Appendicitis.

Background Appendicitis is one of the most common surgical emergency in general surgical practices. Early and prompt diagnosis is necessary to avoid life-threatening complications associated with it. The diagnosis is mainly clinically aided by imaging techniques.

Pattern of sexual behavior in adolescents and young adults attending STD clinic in a tertiary care center in South India.

Background And Objectives: There is an alarming increase in the prevalence of sexually transmitted infections (STIs) among adolescents and young adults of our country. The aim of our study is to depict the current pattern of sexual behavior in this vulnerable sector of population.

Materials And Methods: The study was performed by reviewing the medical records of 1140 adolescents and young adults from January 2015 to June 2015.

Cancer of the gastroesophageal junction: a diagnosis, classification, and management review.

Management of gastroesophageal junction (GEJ) adenocarcinoma is a controversial topic. The rising incidence of this cancer requires a clear consensus to ensure proper management. Application of oncological principles for tumors of the esophagus or stomach is not possible because of comparative differences in the biology of GEJ adenocarcinoma, leading to different therapeutic options.

Crescentic infection related glomerulonephritis in adult and its outcome.

The epidemiology of infection-related glomerulonephritis (IRGN) is changing in recent times both in developed and developing nations. Although published studies showed renal outcome in adult IRGN was not as benign as in children, literature regarding clinical profile and outcome of crescentic form of adult IRGN is scarce; hence, we aimed to study the clinical profile of crescentic IRGN. We conducted a retrospective observational study in patients with crescentic IRGN in adults at the Department of Nephrology, Madras medical college, Chennai between 2009 and 2014.

Clinical profile and outcome of pigment-induced nephropathy.

Background: Pigment nephropathy represents one of the most severe complications of rhabdomyolysis or hemolysis.

Methods: We performed a retrospective observational study to analyze the etiology, clinical manifestation, laboratory profile and outcome in patients with biopsy-proven pigment-induced nephropathy between January 2011 and December 2016. History, clinical examination findings, laboratory investigations and outcome were recorded.

Face and Construct Validity of a Novel Virtual Reality-Based Bimanual Laparoscopic Force-Skills Trainer With Haptics Feedback.

Background: The purpose of this study was to examine the face and construct validity of a custom-developed bimanual laparoscopic force-skills trainer with haptics feedback. The study also examined the effect of handedness on fundamental and complex tasks.

Methods: Residents (n = 25) and surgeons (n = 25) performed virtual reality-based bimanual fundamental and complex tasks.

Paraneoplastic glomerulopathies associated with hematologic malignancies.

Paraneoplastic glomerulopathy (PG) includes a group of glomerular lesions that are not directly related to tumor burden, invasion, or metastasis, but induced by products from tumor cells such as hormones, growth factors, cytokines, and tumor antigens. PG was first described by Galloway in 1922, in which nephrotic syndrome (NS) secondary to Hodgkin's lymphoma was reported. They can present before, at the time of diagnosis, during remission, or at relapse of the hematological malignancies.

Isolated renal involvement of cytomegalovirus inclusion disease in an infant.

Cytomegalovirus (CMV) is the most common cause of congenital infections in humans occurring in 1% of all liveborns. Symptomatic congenital CMV infection involves multiple systems and causes significant morbidity and mortality in newborns. Isolated CMV infection of the kidneys in a living infant has not been reported in literature.

Patulous upper esophageal sphincter - an unusual endoscopic finding.

The upper esophageal sphincter (UES) has various important functions, such as protection of the airway from aspiration and conduct of bolus into esophagus, which are controlled by complex neuronal mechanisms. The functions will be affected when there is malfunction of the UES due to various etiologies. Here we present an 80-year-old male with non-progressive dysphagia and patulous UES incidentally found on esophagoduodenoscopy.

A simplified technique of esophageal self-expandable metallic stent placement without fluoroscopic and endoscopic guidance for treating esophageal carcinoma.

Background/aims: Self-expandable metallic stent (SEMS) placement with fluoroscopic guidance is a commonly used technique to relieve obstruction in patients with esophageal carcinoma. However, it has disadvantages such as radiation exposure. SEMS placement with endoscopic guidance also has the disadvantages of causing discomfort to patients as the endoscope and SEMS assembly are simultaneously used and it needs two experts for the procedure to be performed.

Infection-related glomerulonephritis in a renal allograft.

Infection-related glomerulonephritis (IRGN) is an immune-mediated glomerulo-nephritis, most commonly caused by bacterial infections. Although there is an increased incidence of infectious episodes in renal transplant recipients, IRGN as a cause of de novo glomerulonephritis is rarely seen probably due to impaired immunity. We hereby report a 28-year-old male renal transplant recipient, who developed IRGN following impetigenous skin lesions after six years of transplant.

Is hungry bone syndrome a cause of postoperative hypocalcemia after total thyroidectomy in thyrotoxicosis? A prospective study with bone mineral density correlation.

Background: Hungry bone syndrome is a well-established cause of postoperative hypocalcemia in thyrotoxicosis. To date, the incidence of hungry bone syndrome after total thyroidectomy is unclear. This prospective study examined the incidence of postthyroidectomy hungry bone syndrome and its correlation with preoperative bone mineral density.

Granulomatous slack skin syndrome: Report of a unique case.

Granulomatous slack skin syndrome is a rare variant of cutaneous T-cell lymphoma (mycosis fungoides). It is characterized clinically by redundant skin folds, which show a predilection towards flexural areas such as the axilla and the groin. Histologically, it shows a granulomatous T-cell infiltrate and loss of elastic tissue.