Pub Date : 2023-03-30DOI: 10.14260/jemds.v12i3.362
P. Jersey Shiny, M. Padma Geethanjali
BACKGROUND In this study, we wanted to evaluate to find the significant changes in count of platelets which are one of the blood components with advancing age both in males and females of 30 - 60 years’ age group, to study and analyze the count of platelets in three different age groups of males, to study and analyze the count of platelets in three different age groups of females, to compare the count of platelets in between males and females in different age groups. METHODS This was a hospital based analytical observational cross-sectional study conducted among patients in the 30-60 years’ age group in the Department of Physiology in collaboration with Department of Pathology and Department of General Medicine at Government Medical College, Srikakulam, Andhra Pradesh, India, after obtaining clearance from institutional ethics committee and written informed consent from the study participants. RESULTS Platelet count decreased with increase in age in males from 31-40 years’ age group to 41-50 years’ age group, and count slightly increased with increase in age from 41-50 years’ age group to 51-60 years’ age group in males. But in female’s platelet count increased with increase in age. CONCLUSIONS The present study was done in limited specific age groups that is in between 30-60 years. Further large studies should be done in large population different age groups to know the cause of age specific variations in platelets.
{"title":"Effect of Aging on Platelets in the Individuals of 30 to 60 Years Age Group – A Cross Sectional Study","authors":"P. Jersey Shiny, M. Padma Geethanjali","doi":"10.14260/jemds.v12i3.362","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.362","url":null,"abstract":"BACKGROUND \u0000In this study, we wanted to evaluate to find the significant changes in count of platelets which are one of the blood components with advancing age both in males and females of 30 - 60 years’ age group, to study and analyze the count of platelets in three different age groups of males, to study and analyze the count of platelets in three different age groups of females, to compare the count of platelets in between males and females in different age groups. \u0000METHODS \u0000This was a hospital based analytical observational cross-sectional study conducted among patients in the 30-60 years’ age group in the Department of Physiology in collaboration with Department of Pathology and Department of General Medicine at Government Medical College, Srikakulam, Andhra Pradesh, India, after obtaining clearance from institutional ethics committee and written informed consent from the study participants. \u0000RESULTS \u0000Platelet count decreased with increase in age in males from 31-40 years’ age group to 41-50 years’ age group, and count slightly increased with increase in age from 41-50 years’ age group to 51-60 years’ age group in males. But in female’s platelet count increased with increase in age. \u0000CONCLUSIONS \u0000The present study was done in limited specific age groups that is in between 30-60 years. Further large studies should be done in large population different age groups to know the cause of age specific variations in platelets.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47383234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Dry eye is a condition of tear film which occurs either due to tear deficiency or excessive evaporation of tears which causes damage to the interpalpebral ocular surface and is associated with ocular discomfort symptoms. This ocular disorder is common among general population with a prevalence of 28% among adults. Although diabetic retinopathy and diabetic cataracts are commonly known complications of diabetes, dry eye syndrome or keratoconjunctivitis sicca is also prevalent in diabetic individuals. The prevalence of dry eye in patients with type 2 diabetes mellitus has been reported to be 54%. The diagnosis of dry eye can be determined by decreased tear film stability, assessed by the tear film break up time (TBUT), and reduced tear secretion evaluated by Schirmer’s test. Aims and Objectives To assess the tear film parameters in patients with type 2 diabetes mellitus. To assess the co-relation of tear film parameters with duration of diabetes and HbA1c levels. METHODS A total of 100 eyes of patients with type 2 diabetes mellitus subjects and 100 eyes of non-diabetic age group and gender matched controls, were included in the study. The study was conducted from October 2021 to August 2022. Duration of diabetes mellitus and HbA1c values were documented on all subjects. RESULTS The mean age of the study group and the control group was 60.24 years and 58.32 years respectively. There were more males enrolled than females in both the study group and the control group. Among the study group, the mean values of Schirmer’s test-1 and Schirmer’s test-2 were 20.81±7.2 mm and 12.88±6.01 mm respectively. The values of both Schirmer’s test-1 and Schirmer’s test-2 were lower in the diabetics as compared to the controls. The mean value of TBUT (8.7±3.1 sec) was significantly reduced in diabetic patients as compared to the controls. There was a strong negative correlation of Schirmer’s test-1, Schirmer’s test-2 and TBUT with the duration of diabetes mellitus and with the levels of HbA1c. CONCLUSIONS The incidence of diabetes and dry eye syndrome as separate disease entities is on the rise at present. Dry eye syndrome in diabetes further compromises the quality of life of the patients and thus, should be diagnosed and treated early.
{"title":"Assessment of Tear Film Parameters in Patients with Type 2 Diabetes Mellitus","authors":"Amruthlal Yellamelli, Nitin Batra, Gurvinder Kaur, Samson Rajpal","doi":"10.14260/jemds.v12i3.361","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.361","url":null,"abstract":"BACKGROUND \u0000Dry eye is a condition of tear film which occurs either due to tear deficiency or excessive evaporation of tears which causes damage to the interpalpebral ocular surface and is associated with ocular discomfort symptoms. This ocular disorder is common among general population with a prevalence of 28% among adults. Although diabetic retinopathy and diabetic cataracts are commonly known complications of diabetes, dry eye syndrome or keratoconjunctivitis sicca is also prevalent in diabetic individuals. The prevalence of dry eye in patients with type 2 diabetes mellitus has been reported to be 54%. The diagnosis of dry eye can be determined by decreased tear film stability, assessed by the tear film break up time (TBUT), and reduced tear secretion evaluated by Schirmer’s test. \u0000Aims and Objectives \u0000 \u0000To assess the tear film parameters in patients with type 2 diabetes mellitus. \u0000To assess the co-relation of tear film parameters with duration of diabetes and HbA1c levels. \u0000 \u0000METHODS \u0000A total of 100 eyes of patients with type 2 diabetes mellitus subjects and 100 eyes of non-diabetic age group and gender matched controls, were included in the study. The study was conducted from October 2021 to August 2022. Duration of diabetes mellitus and HbA1c values were documented on all subjects. \u0000RESULTS \u0000The mean age of the study group and the control group was 60.24 years and 58.32 years respectively. There were more males enrolled than females in both the study group and the control group. Among the study group, the mean values of Schirmer’s test-1 and Schirmer’s test-2 were 20.81±7.2 mm and 12.88±6.01 mm respectively. The values of both Schirmer’s test-1 and Schirmer’s test-2 were lower in the diabetics as compared to the controls. The mean value of TBUT (8.7±3.1 sec) was significantly reduced in diabetic patients as compared to the controls. There was a strong negative correlation of Schirmer’s test-1, Schirmer’s test-2 and TBUT with the duration of diabetes mellitus and with the levels of HbA1c. \u0000CONCLUSIONS \u0000The incidence of diabetes and dry eye syndrome as separate disease entities is on the rise at present. Dry eye syndrome in diabetes further compromises the quality of life of the patients and thus, should be diagnosed and treated early.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46235364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.14260/jemds.v12i3.365
Prakash K. Prabhu, Ravikumar B. R., Mukthinath Gugri
Eosinophilic cystitis (EC) is a rare inflammatory condition, first described in 1960 by Brown & Palubinskas.[1] Aetiology remains unclear, although it has been associated with bladder wall injury/allergies in most cases. Histopathologic diagnosis includes transmural inflammation of the urinary bladder with eosinophilia.[2] The patient presents with a spectrum of urological symptoms such as urine frequency (67%), dysuria (62%), gross/microscopic hematuria (68%), suprapubic pain (49%) & urinary retention (10%).[3] In this rare case, an elderly male presenting with clinical & radiological features suggestive of Carcinoma (Ca) bladder ended with a diagnosis of eosinophilic cystitis post-biopsy.
{"title":"A Rare Case of Eosinophilic Cystitis in an Elderly Male Mimicking as Carcinoma Bladder","authors":"Prakash K. Prabhu, Ravikumar B. R., Mukthinath Gugri","doi":"10.14260/jemds.v12i3.365","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.365","url":null,"abstract":"Eosinophilic cystitis (EC) is a rare inflammatory condition, first described in 1960 by Brown & Palubinskas.[1] Aetiology remains unclear, although it has been associated with bladder wall injury/allergies in most cases. Histopathologic diagnosis includes transmural inflammation of the urinary bladder with eosinophilia.[2] The patient presents with a spectrum of urological symptoms such as urine frequency (67%), dysuria (62%), gross/microscopic hematuria (68%), suprapubic pain (49%) & urinary retention (10%).[3] In this rare case, an elderly male presenting with clinical & radiological features suggestive of Carcinoma (Ca) bladder ended with a diagnosis of eosinophilic cystitis post-biopsy.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43127406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.14260/jemds.v12i3.364
Hrushikesh Umakant Kharosekar, Nimesh Jain, Vernon L. Velho
Subcutaneous metastatic nodules are uncommon presentation of underlying malignancy. Cutaneous metastasis is seen in less than 4% cases of all malignancies and is usually seen following initial diagnosis. Lung carcinoma has higher predisposition for bony metastasis compared to other malignancies, however skull metastasis is rare. Cutaneous metastasis is seen in less than 15% cases of lung cancer. These lesions are mostly detected late after the diagnosis of primary tumour in later course of disease. However, an asymptomatic patient presenting with scalp swelling as initial presentation of underlying advances lung malignancy is rare, less than 20 such cases reported in literature till date. Our case is highlighting not only the rarity of such cases but also consider detail evaluation of any scalp swelling.
{"title":"Scalp Swelling a Rare Presentation of Disseminated Lung Carcinoma","authors":"Hrushikesh Umakant Kharosekar, Nimesh Jain, Vernon L. Velho","doi":"10.14260/jemds.v12i3.364","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.364","url":null,"abstract":"Subcutaneous metastatic nodules are uncommon presentation of underlying malignancy. Cutaneous metastasis is seen in less than 4% cases of all malignancies and is usually seen following initial diagnosis. Lung carcinoma has higher predisposition for bony metastasis compared to other malignancies, however skull metastasis is rare. Cutaneous metastasis is seen in less than 15% cases of lung cancer. These lesions are mostly detected late after the diagnosis of primary tumour in later course of disease. However, an asymptomatic patient presenting with scalp swelling as initial presentation of underlying advances lung malignancy is rare, less than 20 such cases reported in literature till date. Our case is highlighting not only the rarity of such cases but also consider detail evaluation of any scalp swelling.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42686549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 48-year-old female, known to be diabetic and hypertensive presented with chronic intermittent abdominal pain in the left upper quadrant for 2 years. The ache was dull and colicky, which was on and off in nature. It has been worsened in the previous 2 months and sometimes associated with nausea and diarrhoea during the onset. She also reported that pain increases during food intake and sometimes it was radiating to the left lumbar region. There was no history of other associated symptoms and no history of any abdominal surgeries. Family history were unremarkable. On examination patient was alert, conscious and oriented with normal vitals. Per abdomen was soft and distended, mild tenderness over epigastrium and left hypochondrium. There was no guarding or rigidity, no mass palpable or organomegaly. Other systems were within normal limits and laboratory tests showed normal findings. Patient had taken USG abdomen initially and it was found to be normal. Later CECT abdomen taken which showed cluster of bowel loops seen in continuation with proximal jejunal loops in the region of anterior pararenal space on left side, which was suggestive of paraduodenal hernia. Small bowel barium study also done which showed cluster of jejunal loops on the left side of upper abdomen.
{"title":"Left Paraduodenal Hernia - A Rare Case of Chronic Abdominal Pain","authors":"Santhosh Puthiya Veettil, Abhijith Krishna Sasikumar, Priyanka Mittra, Abu Anil John, Indrajith Sushruthan","doi":"10.14260/jemds.v12i3.366","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.366","url":null,"abstract":"A 48-year-old female, known to be diabetic and hypertensive presented with chronic intermittent abdominal pain in the left upper quadrant for 2 years. The ache was dull and colicky, which was on and off in nature. It has been worsened in the previous 2 months and sometimes associated with nausea and diarrhoea during the onset. She also reported that pain increases during food intake and sometimes it was radiating to the left lumbar region. There was no history of other associated symptoms and no history of any abdominal surgeries. Family history were unremarkable. \u0000On examination patient was alert, conscious and oriented with normal vitals. Per abdomen was soft and distended, mild tenderness over epigastrium and left hypochondrium. There was no guarding or rigidity, no mass palpable or organomegaly. Other systems were within normal limits and laboratory tests showed normal findings. \u0000Patient had taken USG abdomen initially and it was found to be normal. Later CECT abdomen taken which showed cluster of bowel loops seen in continuation with proximal jejunal loops in the region of anterior pararenal space on left side, which was suggestive of paraduodenal hernia. Small bowel barium study also done which showed cluster of jejunal loops on the left side of upper abdomen.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44665814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rare sites of myoma can present with unusual symptoms, which can cause clinical dilemmas in management. Leiomyomas are benign mesenchymal tumours which arise from smooth muscles. They are commonly found in the uterus. Leiomyoma in the vagina and urethra are a rare occurrence. The literature mostly reported cases of urethral leiomyoma arising from the proximal urethra. In our case, we report a distal urethral leiomyoma, which is an unusual location. This young lady was a 32-year-old Filipino (Asian) lady who presented with mass per vagina, recurrent UTI, difficulty in micturition, discharge per vagina, the feeling of fullness in the vagina, difficulty and unpleasantness during sex for 2.5 years. She came with previous medical records & USG which disclosed many differential diagnoses of PID, cystocele, urethrocele, embryological remnant cyst, urethral diverticulitis and caruncle. She was treated for her complaints, nonetheless, her symptoms gradually became more disabling. After a thorough urogynecological investigation, which included an ultrasound, MRI with contrast and biopsy of the mass, the precise diagnosis of a distal urethral benign leiomyoma’ was made. She underwent a complete surgical excision under general anaesthesia, with excellent post-operative recovery, and was well relieved of all her complaints.
{"title":"An Uncommon Case of Urethral Leiomyoma in a Female","authors":"Sajira Bhasi, Yogesh Bhandari, Munir Sayed, Sanket Shah, Subbian Krishnamurthy","doi":"10.14260/jemds.v12i3.367","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.367","url":null,"abstract":"Rare sites of myoma can present with unusual symptoms, which can cause clinical dilemmas in management. Leiomyomas are benign mesenchymal tumours which arise from smooth muscles. They are commonly found in the uterus. Leiomyoma in the vagina and urethra are a rare occurrence. The literature mostly reported cases of urethral leiomyoma arising from the proximal urethra. In our case, we report a distal urethral leiomyoma, which is an unusual location. \u0000This young lady was a 32-year-old Filipino (Asian) lady who presented with mass per vagina, recurrent UTI, difficulty in micturition, discharge per vagina, the feeling of fullness in the vagina, difficulty and unpleasantness during sex for 2.5 years. She came with previous medical records & USG which disclosed many differential diagnoses of PID, cystocele, urethrocele, embryological remnant cyst, urethral diverticulitis and caruncle. She was treated for her complaints, nonetheless, her symptoms gradually became more disabling. After a thorough urogynecological investigation, which included an ultrasound, MRI with contrast and biopsy of the mass, the precise diagnosis of a distal urethral benign leiomyoma’ was made. She underwent a complete surgical excision under general anaesthesia, with excellent post-operative recovery, and was well relieved of all her complaints.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46311181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.14260/jemds.v12i3.363
Alivia Maitra, Charul Jha
COVID-19, the most infectious pandemic disease arose due to SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) and has caused wide health issues globally. As long as the immune system is functioning normally, infections go unnoticed. Therefore, the coronavirus could threaten the immune system in several ways. Without a question, adequate nutrition plays a significant role in preserving health. Significant immunomodulatory effects are produced by micronutrients such as vitamin C, D, and E, zinc, selenite, and probiotics, which are helpful in infectious diseases. Moreover, it has been demonstrated that a few of these nutrients may be useful in the treatment of COVID-19. This review presents a brief overview of the immune system regarding its protection of the body from COVID-19. Immunity can be acquired through the daily staple meals by the use of plenty of minerals, micro-nutrients, and foods rich in vitamins. Indians can exclusively rely on traditional foods as immunity elevators such as spices, citrus fruits, some vegetables, honey etc. Therefore, this review article summarises possible practices of diet and the benefits of minerals, micro-nutrients and vitamins based on relevant literature available in the Pub Med, and Google Scholar. In the instance of COVID-19, it tries to emphasise the significance of nutrition during times of weakened immunity.
{"title":"Immunological Insight in COVID-19","authors":"Alivia Maitra, Charul Jha","doi":"10.14260/jemds.v12i3.363","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.363","url":null,"abstract":"COVID-19, the most infectious pandemic disease arose due to SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) and has caused wide health issues globally. As long as the immune system is functioning normally, infections go unnoticed. Therefore, the coronavirus could threaten the immune system in several ways. Without a question, adequate nutrition plays a significant role in preserving health. Significant immunomodulatory effects are produced by micronutrients such as vitamin C, D, and E, zinc, selenite, and probiotics, which are helpful in infectious diseases. Moreover, it has been demonstrated that a few of these nutrients may be useful in the treatment of COVID-19. This review presents a brief overview of the immune system regarding its protection of the body from COVID-19. Immunity can be acquired through the daily staple meals by the use of plenty of minerals, micro-nutrients, and foods rich in vitamins. Indians can exclusively rely on traditional foods as immunity elevators such as spices, citrus fruits, some vegetables, honey etc. Therefore, this review article summarises possible practices of diet and the benefits of minerals, micro-nutrients and vitamins based on relevant literature available in the Pub Med, and Google Scholar. In the instance of COVID-19, it tries to emphasise the significance of nutrition during times of weakened immunity.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67062007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.14260/jemds.v12i3.368
Vignesh Varma, Rashmi Sreedhar, Chetan Gowda, Bhoomika R
Scalp injuries are extremely common and although most scalp lacerations/ injuries can be primarily repaired, few require flap coverage. This article discusses the various ways in which we have reconstructed the scalp. This article is a case series of six different cases that required flap reconstruction where six different techniques were used to obtain wound cover with good outcomes. Patients who presented to various smaller hospitals/nursing homes with availability of only a general surgeon and no super specialists in Rural Bangalore with the need for scalp reconstruction were considered for the study. The operative outcome of six different methods of scalp reconstruction/ repair that include four different local flaps, a split skin graft with a wig and a pericranium burr hole drilling followed by split skin graft coverage have been studied. All six cases were followed up for a period of one month post intervention and all of them had good functional and cosmetic outcomes with no complications. There was no incidence of surgical site infection, seroma, or flap/graft failure in the 6 cases included in our study. Both grafts and flaps are equally good modalities in scalp reconstruction, but the choice for which to use should be based on the need of the patient and the type of wound. Grafts can be considered in conditions where there is adequate soft tissue cover over the scalp and in wounds with larger surface area. Grafts have the advantage of being technically simpler and are associated with fewer complications/failure but cannot be used in injuries where the bone is exposed. Flaps have better cosmetic outcome but are technically more challenging.
{"title":"Scalp Reconstruction Techniques for the General Surgeon – A Case Report","authors":"Vignesh Varma, Rashmi Sreedhar, Chetan Gowda, Bhoomika R","doi":"10.14260/jemds.v12i3.368","DOIUrl":"https://doi.org/10.14260/jemds.v12i3.368","url":null,"abstract":"Scalp injuries are extremely common and although most scalp lacerations/ injuries can be primarily repaired, few require flap coverage. This article discusses the various ways in which we have reconstructed the scalp. This article is a case series of six different cases that required flap reconstruction where six different techniques were used to obtain wound cover with good outcomes. Patients who presented to various smaller hospitals/nursing homes with availability of only a general surgeon and no super specialists in Rural Bangalore with the need for scalp reconstruction were considered for the study. The operative outcome of six different methods of scalp reconstruction/ repair that include four different local flaps, a split skin graft with a wig and a pericranium burr hole drilling followed by split skin graft coverage have been studied. \u0000All six cases were followed up for a period of one month post intervention and all of them had good functional and cosmetic outcomes with no complications. There was no incidence of surgical site infection, seroma, or flap/graft failure in the 6 cases included in our study. Both grafts and flaps are equally good modalities in scalp reconstruction, but the choice for which to use should be based on the need of the patient and the type of wound. Grafts can be considered in conditions where there is adequate soft tissue cover over the scalp and in wounds with larger surface area. Grafts have the advantage of being technically simpler and are associated with fewer complications/failure but cannot be used in injuries where the bone is exposed. Flaps have better cosmetic outcome but are technically more challenging.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46477297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-28DOI: 10.14260/jemds.v12i2.339
Gamze Taşkin Şenol, Ibrahim Kürtül
BACKGROUND The aim of the study was to evaluate the number and position of the nutrient foramina in tibia, fibula, femur, humerus, ulna, and radius bones of dry human bones and correlate the results clinically. METHODS For this purpose, 214 long bones were examined. Of the 214 bones studied, 31 were radial, 28 ulnar, 46 humeral, 33 tibial, 22 fibular and 54 femoral. The size, location and the number of nutrient foramina were analysed, and the length of the bone, and the distance of the nutrient foramina from the proximal end of the bone were measured. And the foraminal index was calculated. RESULTS The numbers of primary nutrient foramen (PF) and secondary nutrient foramen (SF) were 183 (85.5 %) and 16 (7.47 %), respectively, and distributed 80.64 % at radius, 92.85 % at ulna, 80.43 % at humerus, 93.93 % at tibia, 86.36 % at fibula, and 83.33 % at femur. The greatest number of SF was on the femur, but not on the tibia and fibula. A statistically significant correlation was seen among; TL-DPF (radius, tibia and femur), DPF-FI (radius, ulna, humerus, tibia, fibula and femur). CONCLUSIONS This study provides important information about the morphology of nutrient foramina in human long bones, knowledge of which will be useful to surgeons in planning orthopaedic procedures and useful to anthropologists in segmental analysis.
{"title":"Morphologic and Topographic Anatomy of the Nutrient Foramen in Human Long Bones and Its Clinical Significance","authors":"Gamze Taşkin Şenol, Ibrahim Kürtül","doi":"10.14260/jemds.v12i2.339","DOIUrl":"https://doi.org/10.14260/jemds.v12i2.339","url":null,"abstract":"BACKGROUND \u0000The aim of the study was to evaluate the number and position of the nutrient foramina in tibia, fibula, femur, humerus, ulna, and radius bones of dry human bones and correlate the results clinically. \u0000METHODS \u0000For this purpose, 214 long bones were examined. Of the 214 bones studied, 31 were radial, 28 ulnar, 46 humeral, 33 tibial, 22 fibular and 54 femoral. The size, location and the number of nutrient foramina were analysed, and the length of the bone, and the distance of the nutrient foramina from the proximal end of the bone were measured. And the foraminal index was calculated. \u0000RESULTS \u0000The numbers of primary nutrient foramen (PF) and secondary nutrient foramen (SF) were 183 (85.5 %) and 16 (7.47 %), respectively, and distributed 80.64 % at radius, 92.85 % at ulna, 80.43 % at humerus, 93.93 % at tibia, 86.36 % at fibula, and 83.33 % at femur. The greatest number of SF was on the femur, but not on the tibia and fibula. A statistically significant correlation was seen among; TL-DPF (radius, tibia and femur), DPF-FI (radius, ulna, humerus, tibia, fibula and femur). \u0000CONCLUSIONS \u0000This study provides important information about the morphology of nutrient foramina in human long bones, knowledge of which will be useful to surgeons in planning orthopaedic procedures and useful to anthropologists in segmental analysis.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48003622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 60-year-old gentleman presented with a single, dark scaly lesion over the forehead for the past 8 years. It started as a small plaque spontaneously, insidious in onset and gradually progressed to the present size. There was no history of trauma, pain or bleeding from the lesion. No history of similar complaints in the family. On examination, there was a large hyperpigmented plaque measuring 15 x 10 cm with well-defined margins and rolled-out edges with ulceration 2 x 0.5cm at the centre. (Fig. 1) Edge wedge biopsy from the lesion revealed a proliferation of basaloid cells which showed features consistent with basal cell carcinoma - atypical mitosis and peripheral palisading. After obtaining anaesthetic fitness, we proceeded with wide local excision with 1cm margin done by the surgical oncology team. (Fig. 2) We then followed by reconstruction of the frontalis sling using fascia lata and covered the defect with a free suprafascial ALT flap with superficial temporal as the recipient artery as an end-to-end anastomosis. (Fig. 3, 4) The donor site was resurfaced with SSG. The histopathology report was consistent with basal cell carcinoma without any perineural involvement. The early postoperative period showed the flap supple and soft with no oedema. (Fig. 5) On regular follow-up, the flap was well settled with good cosmesis. (Fig. 6)
一位60岁的绅士在过去的8年里，前额出现了一个单一的深色鳞状病变。它最初是一个自发的小斑块，发病时很隐蔽，并逐渐发展到现在的大小。没有损伤、疼痛或出血的病史。家族中没有类似投诉的历史。在检查中，有一个15 x 10厘米的大的色素沉着斑块，边缘清晰，边缘卷曲，中心有2 x 0.5厘米的溃疡。（图1）病变的边缘楔形活检显示基底细胞增殖，其特征与基底细胞癌一致——非典型有丝分裂和外周栅栏。在获得麻醉效果后，我们由肿瘤外科团队进行了1cm的大范围局部切除。（图2）然后，我们用阔筋膜重建额肌吊带，并用游离的筋膜上ALT皮瓣覆盖缺损，以颞浅动脉为受体动脉，作为端到端吻合。（图3，4）供体部位用SSG进行了表面置换。组织病理学报告与基底细胞癌一致，无任何神经周围受累。术后早期皮瓣柔软，无水肿。（图5）在定期随访中，皮瓣固定良好，美容效果良好。（图6）
{"title":"Large Frontal Defect Reconstructed with a Suprafascial Anterolateral Thigh Flap and Brow Suspension with a Fascia Lata Frontalis Sling","authors":"Surya Rao Rao Venkata Mahipathy, Manoj Ananthappan, Narayanamurthy Sundaramurthy, Anand Prasath Jayachandiran, Alagar Raja Durairaj","doi":"10.14260/jemds.v12i2.341","DOIUrl":"https://doi.org/10.14260/jemds.v12i2.341","url":null,"abstract":"A 60-year-old gentleman presented with a single, dark scaly lesion over the forehead for the past 8 years. It started as a small plaque spontaneously, insidious in onset and gradually progressed to the present size. There was no history of trauma, pain or bleeding from the lesion. No history of similar complaints in the family. On examination, there was a large hyperpigmented plaque measuring 15 x 10 cm with well-defined margins and rolled-out edges with ulceration 2 x 0.5cm at the centre. (Fig. 1) Edge wedge biopsy from the lesion revealed a proliferation of basaloid cells which showed features consistent with basal cell carcinoma - atypical mitosis and peripheral palisading. After obtaining anaesthetic fitness, we proceeded with wide local excision with 1cm margin done by the surgical oncology team. (Fig. 2) We then followed by reconstruction of the frontalis sling using fascia lata and covered the defect with a free suprafascial ALT flap with superficial temporal as the recipient artery as an end-to-end anastomosis. (Fig. 3, 4) The donor site was resurfaced with SSG. The histopathology report was consistent with basal cell carcinoma without any perineural involvement. The early postoperative period showed the flap supple and soft with no oedema. (Fig. 5) On regular follow-up, the flap was well settled with good cosmesis. (Fig. 6)","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48495927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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