Journal of clinical and diagnostic research : JCDR
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Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. ⋯ There was no difference between the two modalities in terms of fracture union. Complications were lesser but more serious in case of plating. Patient satisfaction was more with plating.
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Mechanism of a regular, monomorphic Wide QRS Complex Tachycardia (WCT) is an important diagnostic challenge in day to day practice for the clinicians and affects further management and prognosis. Many of the WCT and Narrow Complex Tachycardia (NCT) produce certain characteristic changes in lead aVR by which we can differentiate between them. ⋯ Lead aVR, one of the most neglected leads on 12 lead ECG, is a very important diagnostic tool for identification and categorization of different type of tachyarrhythmias. The presence of ST elevation in lead aVR on ECG showing NCT is relatively sensitive for diagnosing AVRT. New aVR algorithm by Vereckei is more sensitive for differential diagnosis of WCT. One should pay careful attention to lead aVR which provides essential diagnostic information.
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Use of Lung Ultrasound For Diagnosing Acute Heart Failure in Emergency Department of Southern India.
Diagnosing heart failure is often a challenge for the healthcare providers due to it's non-specific and usually subtle physical presentations. The outcomes for treatment are strongly related to the stage of the disease. Considering the importance of early and accurate diagnosis, it is important to have an easy, inexpensive, non-invasive, reliable and reproducible method for diagnosis of heart failure. Recent advancement in radiology and cardiology are supporting the emerging technique of lung ultrasound through B-line evaluation for identifying extravascular lung water. ⋯ Lung ultrasound and its use to detect ultrasonographic B-lines is an early, sensitive and an equally accurate predictor of ADHF in the emergency setting as compared to BNP.
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Multimodal analgesia includes regional anaesthesia in the form of nerve block may improve recovery along with optimal rehabilitation and early resumption of day-to-day activity following major surgery. Conventional general anaesthesia consists of premedication, induction, intubation and maintenance. ⋯ Multimodal analgesia has beneficial haemodynamic effects during oral cancer surgery with reliable postoperative analgesia and sedation and less postoperative complication. Dose of drugs used in our study is not associated with any major adverse effect.
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Wilms' tumour, a renal malignancy, primarily occurs in children with a peak incidence between 2 to 5 years age group and accounts for approximately 95% of childhood renal malignancies. Though rarely, it may also occur in adults with an incidence rate of less than 0.2 per million per year. Microscopically, there is no difference between Wilms' tumour of paediatric and adult age groups. ⋯ Nephrectomy was performed and a final morphological diagnosis of Wilms' tumour was given. Immunohistochemical study showed strong Wilms' Tumour 1(WT1) positivity in both blastemal and epithelial components confirming the morphological diagnosis. In view of its diagnostic difficulty and rare occurrence in adults, this case is being reported.