Neuro-Behcet's Disease Presenting as a Young Stroke.

Neuro-Behcet's disease (NBD) is a rare neurological manifestation of the systemic small vessel vasculitis called Behcet's disease. It can present in various ways with predilection for the brain stem, thalamo- hypothalamic regions, cerebellum and basal ganglia. In this case, we describe a case of young stroke that was later attributed to NBD.

Lateral Ventricle to Sylvian Fissure Shunt for Obstructive Hydrocephalus: First Report.

Cerebrospinal fluid (CSF) pathway studies have revealed that the CSF secreted from the choroid plexus of the ventricles after egressing from the fourth ventricle reaches the basal suprasellar cistern and ultimately the sylvian cisterns. From the sylvian cistern, the CSF travels over the cerebral convexity subarachnoid space to reach the superior sagittal sinus and enters the bloodstream. Diverting CSF from the lateral ventricle with a shunt catheter to the sylvian cistern can be an option to treat obstructive hydrocephalus.

Anterior retropharyngeal plate screw fixation with bilateral anterior transarticular screws for odontoid fractures ... a new comprehensive technique.

Introduction: A certain group of odontoid fractures (Anderson and D' Alonzo Type-2) are usually offered surgical treatment. Common surgical option is an anterior odontoid screw. Some of the fractures are not suitable for anterior odontoid screw (anterior oblique, displaced distal fragments and those with atlantoaxial instability) and these are usually offered posterior transarticular screws (Magerl's) or posterior atlantoaxial screw rod/plate fixation (Goel-Harms technique).

A new shunt for obstructive hydrocephalus: ventricle-Sylvian fissure shunt A preliminary report.

Cerbrospinal fluid (CSF) pathway studies have revealed that after egressing from the fourth ventricle reaches the basal supra sellar cistern and ultimately the sylvian cisterns from where the CSF travels over the cerebral convexity subarachnoid space to reach the superior saggital sinus and enters the blood stream. Diverting CSF from the lateral ventricle with a shunt catheter to the sylvian cistern can be an option to treat obstructive hydrocephalus. 2 patients underwent this procedure of diverting CSF from the lateral ventricle with a shunt catheter (Chabbra, India) to the sylvian cistern successfully and had immediate relief of symptoms of raised intracranial pressure.

Comparison of the Clinical Outcome and Complications in Laparoscopic Hernia Repair of Inguinal Hernia With Mesh Fixation Using Fibrin Glue vs Tacker.

Although laparoscopic repair offers a quick and less morbid way of treating hernias, complications like hematoma, seroma, neuralgia, recurrence, mesh infection, hydrocele, etc. are known. The present study was undertaken to compare various clinical outcomes between mesh fixation using fibrin glue and mesh fixation with tacker in a 3-months follow-up.

Efficacy of Sciatic Nerve Block for Pain Management in below Knee Orthopaedic Surgery.

Introduction: Perioperative pain management is an integral part of anaesthesia and patients are most satisfied if there is minimal or no pain after surgery. Sciatic nerve block provides postoperative pain relief after below knee surgery and knee surgery. Many studies with different approaches for sciatic nerve block have been conducted to demonstrate the efficacy of sciatic nerve block with different local anaesthetic drugs over the past decade.

Anterior facetal realignment and distraction for atlanto-axial subluxation with basilar invagination …. a technical note.

Unilateral anterior retropharyngeal approach was used in a case of basilar invagination with atlanto-axial instability. This approach provided easy access to both atlanto-axial joints. Wedge-shaped titanium cages were used to distract the joints and reduce the basilar invagination.

New entry point for C2 screw, in posterior C1-C2 fixation (Goel-Harm's technique) significantly reducing the possibility of vertebral artery injury.

Objective: To reduce the chance of vertebral artery injury in posterior C1 lateral mass and C2 pedicle/pars screw-rod fixation (Goel-Harms technique ).

Method: 49 patients, 30 males and 19 females, 12years - 82 years, underwent posterior C1-C2 fixation from February 2007 till June2013. A new entry point for the posterior C2 screw, 3mm below the midpoint of the C1-C2 joint which is directed medially and downwards into the C2 body , probably avoids the vertebral artery.

Whole-mitochondrial genome sequencing in primary open-angle glaucoma using massively parallel sequencing identifies novel and known pathogenic variants.

Purpose: The aim of this study was to determine whether mutations in mitochondrial DNA play a role in high-pressure primary open-angle glaucoma (OMIM 137760) by analyzing new data from massively parallel sequencing of mitochondrial DNA.

Methods: Glaucoma patients with high-tension primary open-angle glaucoma and ethnically matched and age-matched control subjects without glaucoma were recruited. The entire human mitochondrial genome was amplified in two overlapping fragments by long-range polymerase chain reaction and used as a template for massively parallel sequencing on an Ion Torrent Personal Genome Machine.

Blood pressure control with a single-pill combination of indapamide sustained-release and amlodipine in patients with hypertension: the EFFICIENT study.

Objective: Despite antihypertensive treatment, most hypertensive patients still have high blood pressure (BP), notably high systolic blood pressure (SBP). The EFFICIENT study examines the efficacy and acceptability of a single-pill combination of sustained-release (SR) indapamide, a thiazide-like diuretic, and amlodipine, a calcium channel blocker (CCB), in the management of hypertension.

Methods: Patients who were previously uncontrolled on CCB monotherapy (BP≥140/90 mm Hg) or were previously untreated with grade 2 or 3 essential hypertension (BP≥160/100 mm Hg) received a single-pill combination tablet containing indapamide SR 1.

Ilaprazole: Is this a superior proton pump inhibitor for duodenal ulcer?

Background: Preclinical studies have found ilaprazole to be significantly effective in preventing the development of reflux oesophagitis and gastric secretion in a dose-dependent manner; the drug also has a broad dose range and safety feature. Till date only one clinical study on patients with gastro-oesophageal reflux disease has shown its potency in suppressing gastric acid secretion.

Objectives: To review the published randomized controlled trials (RCTs) assessing the efficacy of ilaprazole in duodenal ulcer (DU) compared to other available proton pump inhibitors (PPI).

MRI brain in monohalomethane toxic encephalopathy: A case report.

Monohalomethanes are alkylating agents that have been used as methylating agents, laboratory reagents, refrigerants, aerosol propellants, pesticides, fumigants, fire-extinguishing agents, anesthetics, degreasers, blowing agents for plastic foams, and chemical intermediates. Compounds in this group are methyl chloride, methyl bromide, methyl iodide (MI), and methyl fluoride. MI is a colorless volatile liquid used as a methylating agent to manufacture a few pharmaceuticals and is also used as a fumigative insecticide.

Randomised clinical trial: the efficacy and safety of pancreatin enteric-coated minimicrospheres (Creon 40000 MMS) in patients with pancreatic exocrine insufficiency due to chronic pancreatitis--a double-blind, placebo-controlled study.

Background: Pancreatic exocrine insufficiency (PEI) results in maldigestion, leading to abdominal pain, steatorrhoea, malnutrition and weight loss.

Aim: To assess the efficacy and safety of pancreatin (Creon 40000 MMS) in treating PEI due to chronic pancreatitis (CP).

Methods: This was a 1-week, double-blind, randomised, placebo-controlled, parallel-group, multicentre study in India.

Future of thrombolytic therapy--an Indian context.

Acute myocardial infarction has two main treatment modalities in the form of direct angioplasty (PAMI) and intravenous thrombolysis. PAMI is statistically clearly superior to intravenous thrombolysis. However, as ground reality in Indian conditions PAMI remains a distant ideal option for many ST elevation MI patients.

Erythema nodosum and bilateral breast abscesses due to Salmonella enterica serotype Poona.

A woman presented with erythema nodosum followed by bilateral breast abscesses without a gastrointestinal manifestation, due to a rare serotype of Salmonella, namely, Salmonella enterica serotype Poona. This is the first reported case of erythema nodosum presumably associated with Salmonella infection without a gastrointestinal manifestation.

No-mesh inguinal hernia repair with continuous absorbable sutures: a dream or reality? (A study of 229 patients).

Background/aim: The author has published results from two series based on his new technique of inguinal hernia repair. Interrupted sutures with a nonabsorbable material were used for repairs in both theses series. The author now describes the results of repairs done with continuous absorbable sutures.

Successful RF ablation of atrial tachycardia from the non-coronary aortic cusp.

A 51-year-old lady presented with recurrent episodes of supraventricular tachycardia since 1 year. EP study revealed easily inducible atrial tachycardia. Endocardially, the earliest activation site was found in the His bundle region (-18 ms).

Physiological repair of inguinal hernia: a new technique (study of 860 patients).

The author has developed a new operation technique based on the physiological principle that provides dynamic posterior wall for inguinal hernia repair. Results of the first series of 400 patients were published in 2001 (ANZ J Surg 71:241-244, 2001). Now the author has described the results of the second series of 860 patients having 920 hernias with follow-up for more than 7 years.

Surgical physiology of inguinal hernia repair--a study of 200 cases.

Background: Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured as a result of current techniques of operation, though factors that are said to prevent hernia formation are not restored.