Anaesthetic management of a patient with severe aortic stenosis for caesarean section: a case report.

Aortic stenosis (AS) is an uncommon valvular heart disease presenting during pregnancy. Mild to moderate AS is associated with favorable pregnancy outcome but severe AS can worsen the hemodynamics during the peripartum period and precipitate heart failure, pulmonary edema, thus carrying significant maternal and fetal morbidity and mortality. Percutaneous balloon valvuloplasty can be used as a palliative procedure that allows for completion of pregnancy before definitive repair. We present a case of severe AS posted for caesarean section who was successfully managed under general anaesthesia and had an uneventful recovery.

Poncet's Arthritis in a Patient with Multidrug-Resistant Tuberculosis.

A 17-year-old female diagnosed to have multidrug-resistant pulmonary tuberculosis (MDR-TB), presented with Poncet's arthritis which responded to second-line anti-TB treatment. Poncet's disease is more commonly present in association with extra-pulmonary TB and involves large and small joints. However, our patient had pulmonary MDR-TB and small joint involvement.

Elimination of palatoradicular groove: a combined endo-perio effort.

Palatoradicular groove is an anomaly which is found more frequently in upper lateral and central incisors. This condition may lead to endo-perio lesions. A 19- year- old female presented with chief complaint of swelling and pus discharge from the gums of the right side of the upper front teeth and she also complained of loose tooth and intermittent pain. On clinical examination, probing pocket depth of 10 mm, grade II mobility and extrusion of the tooth was found. A combined endo-perio treatment was performed and elimination of the groove, pain and reduction in probing pocket depth and mobility was achieved. The purpose of this case is to highlight an interdisciplinary approach towards the management of an anomaly which may affect the endodontic status of the tooth and periodontal health of the patient.

Impact of Total Contact Plaster Boot via off Loading Practice in Trophic Ulcers of the Feet: Case Series

Trophic ulcers have emerged as one of the major complications following diabetes mellitus (DM) and Hansen’s diseases (HD). In this case series, the study attempted total contact plaster boot using a readily available plaster of Paris to treat trophic ulcer for 10 subjects. A total of five subjects with DM and five subjects with HD were included based on the study criteria. Pre and post test measure of wound measurement size following total contact plaster boot were taken as an outcome measure. All ten subjects showed decrease in size of wound following fifteen days of treatment. No adverse effects were associated with this type of treatment. Subjects with trophic ulcer may benefit from the application of total contact plaster boot.

Sub Acromial Debridement Surgery with Acromioplasty for Chronic Shoulder Pain - Biomechanical Challenges in Physical Rehabilitation

Arthroscopic sub acromial debridement surgery with acromioplasty is one of the shoulder surgeries performed to treat chronic shoulder pain. This surgical procedure is usually indicated in sub acromial impingement syndrome of shoulder, degenerative rotator cuff tears, severe functional limitation of shoulder joint and often surgery was performed in cases where all the conservative management had failed in the treatment of chronic shoulder pain. Even though the patient would be referred for early rehabilitation, post operative management of this surgical condition is highly challenging. Movement of the shoulder joint is often related with scapulo-thoracic joint, acromio-clavicular joint and sternoclavicular joint and the shoulder movements are governed by various different muscular forces from these joints. Failure to understand this biomechanical complexity of shoulder joint during post operative rehabilitation results in failure of the surgical outcome and might cause severe functional limitation with recurrent shoulder pain. Often in clinical practice, greater emphasis is given to achieve and regain movements in shoulder joint at the expense of the joint stability. However, inadequate scapular stability might further predispose the shoulder joint to excessive loading and results in repetitive injuries leading to chronic shoulder pain. This might affect the surgical and clinical outcome of the acromioplasty and result in surgical failure. Hence, surgeons and clinicians need to understand the biomechanical contributions in the post operative rehabilitation of the shoulder joint. The present case report emphasises the biomechanical model of post operative rehabilitation of a patient who had arthroscopic sub acromial debridement with acromioplasty.