Pak J Med Sci
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Case Reports
Neglected Bilateral Posterior Shoulder Fracture Dislocation in an Uncontrolled Seizure patient.
Posterior dislocation of the shoulder is a rare injury that occurs secondary to trauma and seizures. Diagnosis is often missed and treatment is challenging. ⋯ Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging. In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up.
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Trendelenburg positioning is a common approach used during internal jugular vein (IJV) cannulation. No evidence indicates that Trendelenburg positioning significantly increases the cross-sectional area (CSA) of the IJV in obese patients. The primary aim of this study was to determine the effectiveness of Trendelenburg positioning on the CSA of the right internal jugular vein assessed with ultrasound measurement in obese patients. ⋯ Trendelenburg positioning does not significantly increase the mean CSA of the right IJV in obese patients. In fact, in some patients, this position decreases the CSA. The use of the Trendelenburg position for IJV cannulation in obese patients can no longer be supported.
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To analyze alterations in thyroid function and the correlation between results of thyroid function test and mortality in medical and surgical intensive care unit (ICU) patients. It also aimed to evaluate the effect of thyroid dysfunction in ICU patients and their need for mechanical ventilation (MV). ⋯ There is a significant association between ESS and mortality in ICU patients. Future studies should determine whether abnormal thyroid function increases the risk for MV in ICU patients.
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To compare the postoperative analgesic efficacy of ropivacaine 0.175% and bupivacaine 0.175% injected caudally into infants for lower abdominal surgery. ⋯ This study indicated, that a concentration of 0.175% ropivacaine and 0.175% bupivacaine administered to the infants via caudal route both provided effective and similar postoperative pain relief in infants, who underwent lower abdominal surgery.
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To assess and compare the relative efficacy of silk ligation and diathermy coagulation techniques in controlling bleeding during tonsillectomy in the first 24 hours. ⋯ Primary haemorrhage occurring during tonsillectomy is a serious threat and control of bleeding during the procedure should therefore be meticulous. Both suture ligation and coagulation diathermy for control of bleeders during the procedure by dissection method are equally effective.