Remote-access thyroidectomy techniques aim to address patient concerns regarding visible cervical scars but are often limited by cost, equipment, and learning curves. We describe a novel open technique thyroidectomy via an infraclavicular open scar-concealing approach that re-locates the incision to a clothing-concealed infraclavicular site while preserving the principles of conventional open thyroidectomy.
We report two such cases. Case 1: A 30-year-old male presented with right forearm swelling and pain; examination revealed a non-mobile, fluctuant intramuscular swelling. Case 2: A 30-year-old female had a 3-month history of midline chest pain with a mobile, fluctuant swelling over the xiphisternum. In both cases, aspirated pus showed numerous pus cells with few Gram-negative bacilli. Culture revealed non-lactose fermenting, smooth convex colonies identified as Salmonella Typhi by biochemical tests, Vitek 2 (bioMérieux), and serology. The isolates were susceptible to ceftriaxone, ciprofloxacin, azithromycin, cotrimoxazole, and ampicillin, but resistant to chloramphenicol. Both patients were immunocompetent, with no history of trauma, diabetes, or haemoglobinopathy, and responded well to antibiotic therapy. These cases highlight the need for clinical awareness of atypical presentations of S. Typhi osteomyelitis and the importance of timely diagnosis in endemic regions.
A seemingly straight-forward case of community-acquired pneumonia revealed underlying Eisenmenger syndrome. This case highlights the relevance of this condition to tropical practice as well as some useful diagnostic and therapeutic considerations.
Gartner's duct cyst is a congenital, benign, usually small-sized and asymptomatic cyst arising from the remnants of the Wolffian duct. Larger cysts can cause dyspareunia, pelvic swelling and urinary symptoms.
Diabetic foot ulcers (DFUs) are among the most debilitating complications of diabetes mellitus, substantially increasing morbidity, healthcare costs, and risk of amputation. We prospectively evaluated the efficacy of various tailored surgical offloading procedures in promoting biomechanical ulcer healing and preventing recurrence. No patient experienced ulcer recurrence or new ulcer formation during a mean follow-up of one year. Revision surgery was not required in any case. Individualised surgical offloading techniques are viable and effective for DFUs as they address the underlying biomechanical derangements that predispose to ulceration.
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