Background: Primary Non-Hodgkin’s Lymphoma (NHL) of the spine is an uncommon presentation of extra nodal lymphoma. Chemotherapy, radiotherapy, and biological therapy are standard treatment protocols for patients with NHL. In patients with neurologic compression due to primary NHL of spine, the role of surgical decompression still remains unclear. We retrospectively evaluate the improvement of neurological function and the survival rate following decompressive surgery of 17 NHL patients involvin...
- Issue: 2, Volume: 2
Addressing the Surgical Shortage: Revisiting Residency Training Requirements for International Medical Graduates
The American Association of Medical Colleges projects a shortage of between 19,800 and 29,000 physicians in the surgical specialties by 2030. General surgery projects the greatest shortfall among surgical specialties, in part because of high rates of graduating residents pursuing fellowships. International medical graduates, many of whom trained in the US, have become a major part of the physician workforce in other specialties, but represent a small part of general surgeons in practice and tra...
Surgical Management of Adult High-Grade Spondylolisthesis by Partial Reduction, Decompression and Instrumented Circumferential Fusion
Background: Treatment options of symptomatic High-Grade Spondylolisthesis (HGS) are surgery. But surgical treatment of HGS is often difficult and related techniques are still debated. Objectives: To assess the outcome of adult HGS by partial reduction, instrumentation and circumferential fusion in a single institution.
- Issue: 1, Volume: 2
This is a case report of 68-year-old lady presented with several months of intermittent epigastric pain and bloating without any relationship to meals. An abdominal computed tomography detected an intussusception at the terminal ileum without proximal obstruction. Subsequent colonoscopy revealed a large caecal tumour with microscopy suggesting diffuse large B-cell lymphoma. The ideal management of solid tumour lymphoma of the bowel is contentious depending on whether the patient is seen by an o...
Objective: To analyze the frequency, risk factors and management of ectopic pregnancy. Design: Cross-sectional study. Place and Duration of study: The Department of Obstetrics and Gynecology, Royal Commission Medical Center, Yanbu, Saudi Arabia from January 01, 2015 to December 31, 2019.
A 94-year-old female presented to her family General Practitioner with what appeared to be a large right thigh infected seroma or haematoma. She reported having a painful right thigh lump for 8 weeks with no history of trauma and had also taken antibiotics which did not improve her symptoms. On examination, there was a tender, fluctuant and bruised area approximately 10 by 8 cm in size. Ultrasound confirmed the presence of a large hypoechoic mass in the right groin with well defined margins and...
Introduction: Rectourethral Fistulas (RUF) after Radical Prostatectomy (RP) are an uncommon but serious complication, and there is no consensus on their management. In this study, we report the results of a standardized management procedure for RUF after RP.
- Issue: 5, Volume: 1
Objectives: The aim of this study is to present single surgeon’s experience in the early surgical repair of Congenital Completely Buried Penis (CCBP) in a series of 103 boys and review of literature. Methods: This is a retrospective study of management of patients of CCBP at the median age of 28 months between May, 2012 and March, 2019. All the children were followed up for 6 months.
Prevention and Excision of Spinal Cord Scar Following Spinal Cord Injury Results in Motor Function and Spinal Cord Regeneration
Background: This paper shows originality for the treatment of acute spinal cord injuries by the absorption of fibrinogen by the omentum. This paper also shows that the statement by Ramon y Cajal that the reason spinal cords don’t heal is that the scar that routinely occurs at the point of spinal cord injury must be removed in order for axons to progress into the distal spinal cord.
The Use of Ambulatory Emergency Care Unit as Supply-Side Drivers for Non-Emergency Surgical Patients during COVID-19 Pandemic Lockdown: An Audit Report from a Tertiary Care Center
Background: Surgical Ambulatory Emergency Care (AEC) provides better patient flow, improves patient experience, and reduces hospital admissions. This study aims to assess the functionality pattern of an AEC for acute surgical patients in a tertiary care hospital.
Wound healing is a complex process with steps of haemostasis, the inflammatory and proliferative phases, remodelling. The difficulties in the edge of the wound can be detrimental to healing and may cause a delay in wound healing. Sucralfate has been used in gastric and duodenal ulcers. Studies have shown a beneficial effect on skin lesions, dermatitis, and burns. In this article, we share our experience of using sucralfate in the case of a non healing ulcer.
- Issue: 4, Volume: 1
COVID-19 was first described in Wuhan-China and soon after delaring a pandemic according to WHO. In Brazil, it truly became a health problem, with more than 2 million cases. Clinically, the disease manifests as pneumonia, but abdominal surgeons have been called since the beginning to face acute abdominal syndromes associated with this disease. The most were related to mesenteric lymphadenitis and managed without surgery. But as the disease worsened a more critical presentation presented are rel...
Non healing wound is a common problem encountered by plastic surgeon. There various causes due to which the wound becomes non healing and fails to heal. However there is no well-established method that can accelerate the wound healing rate. Prolotherapy is a method of injecting some irritant locally into the wound and is claimed to hasten the healing time. This article highlights the role of prolotherapy in management of amputation stump.
COVID-19 pandemic is a testing time for every branch of medicine which opened up a new challenge of protecting themselves meantime treating the sick without compromise. For example, treating burns patients, who are very vulnerable for COVID-19 infection. One of the most important step in minimizing the spread of COVID-19 infection is by maintaining social distancing. Now Telemedicine is being revisited as a tool in implementing social distancing, thus providing a safer healthcare.
The pressure ulcer also called bed sore or decubitus ulcer is one of the complications seen in bedridden patients. Management of these ulcers is often challenging. But there is no well-established method that accelerates the wound healing rate. In this article we would highlight the role of laser therapy in wound bed preparation in the case of a pressure ulcer.
Telemedicine plays an important role in imparting healthcare facilities worldwide in special situations like the COVID-19 Crisis. Use of technology in healthcare has come a long way. Special cameras for surveillance and interaction have been used in fields of industries, offices, home based and national security systems etc. Here we describe our experience regarding the use of Pan-Tilt camera in Tele-interaction for imparting healthcare services during the time of corona pandemic.
- Issue: 3, Volume: 1
Breast Tumor Volume to Breast Volume Ratio Analysis to Predict Breast Cancer Axillary Node Positivity Rates
Background: Prognostic scoring systems such as TNM  and NPI (Nottingham prognostic index)  use maximal tumour diameter for staging. Breast cancer is three-dimensional therefore tumour volume and weight could be more accurate biological predictors. Nodal spread may also be different for tumors occupying a greater or lesser proportion of the breast. This study aims to measure breast cancer weights as a proportion of the mastectomy specimen weight and to compare node positivity rates in high...
Pressure ulcer or pressure sore is one of the complications seen in bedridden patients. Management of these ulcers is often challenging. But there is no well-established method that accelerates the wound healing rate. Prolotherapy is a technique that involves injecting some irritant locally in the wound that is claimed to hasten the healing. This article highlights the role of prolotherapy in wound bed preparation.
Background: Patients with chronic portal venous obstruction can develop portal cavernoma and obstruction in the biliary system, which is termed as portal biliopathy. Symptomatic portal biliopathy requires intervention. It is a complex problem and therapeutic strategy has not been optimized. Materials and methods: Retrospectively, details of 23 patients who were admitted between June 2015 and November 2018 with symptomatic portal biliopathy were analysed. Endoscopic stenting was the preferred i...
Management of Congenital lung malformations in Neonates-Northern Area Armed Forces Hospital Experience
Objectives: Congenital Lung Malformations (CLM) are rare and vary in their clinical presentations depending on the extent of lung involvement. Congenital Cystic Adenomatoid Malformation (CCAM), Congenital Lobar Emphysema (CLE) and Bronchogenic Cyst (BC) are all congenital lung malformations that present in imaging studies as abnormal air, fluid or fluid filled cysts. Neonates with CLM can present with respiratory distress at birth or may remain asymptomatic for a long period and are diagnosed i...
Quality of Life and Productivity of Transplant Professionals is Improved Using a Mobile Application for Communication during Organ Procurement and Transplantation
A limitation on the efficiency of procurement and utility of donated organs is the simultaneous coordination and communication among Organ Procurement Organizations (OPO) and transplant support teams. This applies to each organ which may be utilized for any given donor. Results of this study, currently “In Production” in the journal Progress in Transplantation, showed an improvement in communication and coordination using a real time effective, HIPAA compliant tool among procurement and transpl...
- Issue: 2, Volume: 1
Comparison of Peritoneal Closure vs. Non-Closure after Non-Infected Elective Laparotomies with Midline Incision
Introduction: There is no consensus data regarding closure or non-closure of peritoneum in laparotomy and this topic remains a controversy among surgeons. Material and method: In this prospective interventional study 124 patients undergoing laparotomy with midline incision have been assessed from March 2019 till September 2019 in Imam Hossein Medical Center. Sixty-two of these patients had peritoneal closure with continuous absorbable suture, while 62 other assigned to the non-closure group.
Bouveret’s syndrome is a rare form of gallstone ileus caused by the passage and impaction of a large gallstone through a cholecystoduodenal fistula into the duodenum, resulting in gastric outlet obstruction. It is a rare form of gall stone ileus (1-3% of cases of gall stone ileus; gall stone ileus itself is extremely rare occurring in only 0.3-0.5% of patient with cholelithiasis) and causes significant morbidity and mortality1. It is common in elderly female patients with multiple comorbidities...
Conversions and Complications – A Retrospective Analysis of 834 Laparoscopic Cholecystectomy in a Teaching Hospital
Background: Laparoscopic Cholecystectomy (LC) is the ‘gold standard’ operation for cholelithiasis, but still carries significant morbidity and occasional mortality. Patient and methods: A retrospective analysis of 834 LC over a period of 4 years in a single surgical unit in a tertiary care medical college was performed and various factors affecting conversion and complications reviewed.
Post burn contractures of the hand are very common. The most important aspect of release of these contractures is to provide a functional hand. There are various methods of release of these contractures depending on if they are on the dorsal or volar aspect of the hand. We have used distraction assisted management of post burn contracture of the little finger.
Arthroscopic Treatment of Osteoid Osteoma: A Brief Review of Literature from Years 1935 to Years 2007
Osteoid osteoma is a benign tumour in adolescents and young adults. The clinical manifestations are generally typical nocturnal pain that prevents sleep and that is alleviated with aspirin. When the typical clinical and radiological features are present, diagnosis may arrive in connection with an unusual location. The lesion is removed arthroscopically, and histopathologic findings confirm the preoperative diagnosis of osteoid osteoma. Here, we document a brief review of literature. In this rev...
- Issue: 1, Volume: 1
Burnout is a psychological state of mind which arises from distress and disfavor with a work-related course of life. Burnout has been linked in recent years to life in the medical world, during schooling, training, and subsequent professional practice. In fact, burnout has become an in-word for any topic of medical exasperation today. For those of us older folks in medicine, the question seems to be “did we face burnout at some earlier time and not perceive it?”. And so the definition seems to ...
Thermography for Functional Mapping during Waking-State Craniotomy Localization of Cortical Area Response to Voluntary Movement
We performed thermal images of the brain during tumor surgery. Temperature increases corresponded temporally and spatially to directed movements. Good correlation with conventional methods of intraoperative brain mapping also was obtained. Focal temperature decreases provided accurate localization of underlying tumors. Thus, thermal imaging represents potentially valuable input for neuronavigation system.
The Complete Evidence that Starling’s Law is Wrong: The Correct Replacement is the Hydrodynamic Phenomenon of the Porous Orifice (G) Tube
Introduction and objective: To report the hydrodynamic of a porous orifice (G) tube as replacement for the wrong Starling’s law. Material and methods: Hydrodynamics of the G tube, based on capillary ultra-structure, were studied. The effect of changing G tube orifice diameter, proximal pressure and distal pressure on the side pressure and chamber (C) pressure were evaluated. The physiological proof that the capillary works as G tube not Poiseuille’s tube is provided.
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