Journal of clinical and diagnostic research : JCDR
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Knowledge about the ossification of the Carotico-Clinoid Foramen (CCF), as it forms a potential site for compression of the internal carotid artery may be beneficial for neurosurgeons and radiologists. ⋯ Considering the immense anatomical surgical and radiological importance of morphology of ACP, OS and CCF, this study highlighted the detailed morphometry of these structures. The study also has explained the sexual dimorphism in their morphology.
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Head Trauma (HT) is a major cause of death, disability and important public health problem. HT is also the main cause of hyperglycaemia that can increase mortality. ⋯ Hyperglycaemia after severe TBI (RBS ≥ 200) is associated with poor outcome. It can be a predictive factor for mortality rate, ICU stay, GCS arrival, VAP & RDS, hospital stay and ISS. Management of hyperglycaemia with insulin protocol in cases with value >200mg/dl, is critical in improving the outcome of patients with TBI.
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Case Reports
Innovative Application of a Microlaryngeal Surgery Tube for difficult Airway Management in a Case of Down's Syndrome.
An 11-year-old male child, known case of down's syndrome with congenital oesophageal stricture was posted for oesophageal dilatation. Preoperative airway assessment revealed a high arched palate, receding mandible and Mallampati Score of 2. During surgery, after loss of consciousness which was described as loss of eyelash reflex and adequate jaw relaxation, direct laryngoscopy and endotracheal intubation was attempted with a cuffed endotracheal tube number 5.0mm ID (internal diameter). ⋯ Later, intubation via a Micro Laryngeal Surgery (MLS) cuffed tube 4.0mm ID was attempted. The MLS tube advanced smoothly and there was no associated leak on positive pressure ventilation. Thus by innovative thinking and avant-garde reasoning, a definitive airway device could be positioned with no other suitable alternative at hand.
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Case Reports
A Novel Approach for the Retrieval of Broken Catheter Fragment - Using Balloon Dilatation Technique.
In this era of an ever increasing number of interventions in cardiology, there is a parallel increase in the number of complications associated with these interventions, such as broken catheter tip and guide wire embolisation. The most commonly used and effective method for the percutaneous retrieval of such broken fragments is a goose neck snare. However in cases where this technique has been a failure, newer and novel innovations have been implemented for the retrieval of such broken fragments. ⋯ During the procedure the internal mammary catheter was broken in the left ventricle and subsequently the broken fragment was embolised to the left common carotid artery. The broken fragment was snared down upto the common iliac but could not be retrieved out of the sheath. A novel approach was used, consisting of negotiating a coronary guide wire across the broken catheter and inflating a balloon in the catheter fragment which helped to achieve a co-axial alignment with the arterial sheath and hence by which it was possible to retrieve the broken catheter fragment out of the circulatory system.