ABSTRACT
Stroke is a major cause of death worldwide. Prompt treatment and decision-making is essential for good outcomes. The two major therapeutic approaches for acute ischemic stroke are thrombolytics and neuroprotectants. Piracetam, a nootropic drug aims to increase cerebral blood flow, enhance oxygen extraction, restore membrane fluidity and modulate neurotransmission. Likewise, citicoline has been shown to positively influence cerebral plasticity and neurorepair processes. The present article aims to offer insights on the current management of acute stroke and to position piracetam and its combination with citicoline in the management of acute stroke and post-stroke sequelae based on an expert panel discussion.
ABSTRACT
An internal hernia is any protrusion of a solid organ or a hollow viscus through a defect within the abdominal cavity. Paraduodenal hernias are rare, but are the most common variety of internal hernias. We present a rare case of a left sided paraduodenal hernia in a 26 years old otherwise healthy male who presented in emergency department with intermittent colicky upper abdominal pain. Left paraduodenal hernia was diagnosed pre operatively in a computer tomography scan. Hence patient was offered a laparoscopic repair. Our search via online search engines revealed very few case reports of Paraduodenal hernias which were repaired laparoscopically. We believe that in expert hands, paraduodenal hernias should be managed with laparoscopic technique as it significantly reduces morbidity and hospital stay.
ABSTRACT
Diaphragmatic hernia (DH) usually occurs in childhood; however, in adult it is uncommon. Most common aetiology of DH in adult is trauma while spontaneous DH is a rare entity accounting for <1%. The management is primarily surgical repair in the form of open or laparoscopic approach; the later has been associated with low morbidity, mortality and excellent long term outcomes with low rate of recurrence. In this case series, confirmation of the diagnosis was done by CT scan and by laparoscopy in all the patients; laparoscopic repair was performed in all the patients along with thoracoscopic aid in two cases. We found that minimal access techniques can be safely done in DH; in conditions when the herniated content are difficult to get reduced laparoscopically alone, a simultaneous thoracoscopy has helped in great deal in reducing the content and completing the procedure entirely by minimal access techniques. This gives all the advantages of minimally invasive approach like less postoperative pain, shorter hospital stay, quicker recovery and low recurrence rate; provided tissue repair is done in tension free manner by an experienced laparoscopic surgeon.
ABSTRACT
Compound fractures of tibia are one of the commonest fractures seen in clinical practice. Traditionally their treatment involved the application of external fixator and then definitive surgery once the wound has healed. This prospective study of 47 patients was undertaken to evaluate the results of unreamed interlocking nailing in such fractures. They were followed up for an average of 14 months. All the fractures united at an average of 24 weeks and there were no major complications. In our study17 cases (36.7%) had excellent results, 19cases (40.4%) had good results, 11 cases (23.4%) had fair results and none of the cases had poor results as per criteria laid down by Johner and Wruhs (1982) [15]. Our study does suggest that unreamed interlocking nailing is a good method of primary internal fixation of compound (grade I to IIIB) fractures of tibia.
ABSTRACT
The presence of foreign objects in the pulp chamber of fractured permanent teeth is a rare phenomenon and often diagnosed accidently .These foreign bodies are most commonly self inflicted by young patients and remain impacted within the pulp canal thereby acting as potential source of infection and painful conditions1. In the present case report, we present successful endodontic management of stapler pin lodged in fractured maxillary central incisor with challenge of open apex in young patient using biodentine as a novel apical matrix.