Reimerdanielsen9670

Retrospective chart review of all children (aged-one month to 16 years) admitted in our paediatric intensive care from June to November 2016 was done to determine the indication of different laboratory tests. LBT indications were defined into diagnostic/case findings/screening tests to make a diagnosis; haemostatic tests (to monitor function or identify before clinical signs and symptoms) and therapeutic /monitoring tests to get the level of drug directly or getting level of marker as a guide to therapy. Laboratory tests reports which were within normal range more than once were labelled as in-appropriate tests. In total 274 patients, Haemostatic tests were performed for mean of 35.18±56.72 times (range of 0-429), monitoring for mean of 9.38±20 times (range 0-165), and therapeutic tests (3.26±11.25). Most common tests included serum Sodium levels (7.83±12.73), Serum Potassium (8.19±12.80), bicarbonate (7.75±11.9). 13.40±9.11 tests were done on first day and 13.0±8.49/day tests were performed afterwards. Cumulatively 54.31±74.21 tests were performed/ patients out of which 18.5±37.82 were inappropriate.Hydatid disease-a parasitic medical condition caused by echinococcus, is one of the oldest diseases known to mankind. Primary hydatid disease of the chest wall is very rare and only nine cases have been reported so far in the literature. This study presents a case of primary hydatid chest wall in a patient with right infraclavicular swelling that increased in size suddenly. A 35 year-old lady presented to the Surgical Unit of Khyber Teaching Hospital with a two and a half year history of right infraclavicular chest wall lump which increased in size abruptly Upon investigation the Computed tomographic (CT) scan of the chest showed a complex multiseptated hypodense lesion in the right pectoralis muscle with no involvement of underlying clavicle or rib. She was booked for exploration under general anaesthesia electively. The lump revealed multiple daughter cysts with the characteristics of germinal layers and ecto cysts of hydatid cysts. The patient had a stable recovery in the postoperative period and was sent home on medical treatment. On follow up she was fine; the wound had healed and there was no swelling in the surgical site. Primary hydatid disease of the chest wall is a very rare disease, so this case is a piece of good evidence to consider hydatid cyst in the differential diagnosis of any cystic mass in any part of the body, especially in endemic areas. Radical peri-cystectomy followed by chemotherapy with albendazole is all that is needed for the treatment.A 25 years male working as labourer in Middle East presented with episodic chest pain and productive cough for last 10 years. There was polycystic lesion in left lower chest cavity having separate arterial supply from descending aorta on radiology. It was diagnosed as intralobar sequestration. Operative findings confirmed the presence of separate blood supply from descending aorta and patent bronchial connection of intrapulmonary sequestration to the rest of the lung parenchyma. There are only few case reports in the literature describing this entity. Posterobasal segmentectomy was done with stapling of communicating bronchus.Patients with ischemic heart disease and left ventricular dysfunction need evaluation for myocardial viability. Two cases of myocardial perfusion imaging for viability study are discussed. Viability imaging is performed with 99mTc-Sestamibi (99mTc-MIBI), acquiring images with and without nitrate enhancement. Improvement in perfusion in nitrate enhanced images is suggestive of myocardial viability. In these cases, there was paradox effect showing reduced uptake on nitrate enhanced images than on resting images. Technical factors of equal radiotracer dose in both studies, pre-imaging time and processing were considered. Since no such contributing factor was delineated, it is postulated that phenomena can occur due to differential effects of oral glyceryl triglyceryl trinitrate (GTN) on normal and diseased vessels.A 6-year-old boy presented to ER with acute pain in right iliac fossa without any history of lower urinary tract symptoms, haematuria and urinary catheterization. Ultrasound showed loculated cystic area in pelvis with non-visualized appendix. A CT scan abdomen and pelvis revealed loculated, multi-septated cystic lesion in right hemipelvis thought to be a collection from possible appendicular inflammation / perforation. The laboratory findings revealed raised CRP and normal urine routine examination and culture. Exploratory laparotomy revealed cystic urinary bladder growth involving dome with normal appendix, partial cystectomy was done. Histopathology confirmed polypoid cystitis with no evidence of malignancy. This is a very rare presentation of polypoidal cystitis, not previously reported in literature.An elderly man had recurrent admissions with large symptomatic pericardial effusions. Initial computed tomography (CT) of thorax, abdomen and pelvis and pericardial fluid analysis did not reveal underlying cause. On subsequent presentation, pericardial window was formed but repeat pericardial fluid analysis and biopsy failed to give a diagnosis again. He then presented approximately after four months with worsening symptoms of dyspnoea and weight loss. General physical examination at that point noted inguinal lymphadenopathy. Empesertib price Repeat imaging with CT and magnetic resonance imaging (MRI) showed features of metastatic malignancy. Tissue diagnosis from inguinal lymph nodes proved to be diffuse large B-cell lymphoma (DLBCL).Cleidocranial dysplasia is a rare autosomal dominant disorder of bones mainly affecting bones formed by intra-membranous and endochondral ossification. It presents clinically as brachycephalic skull, frontal bossing, depressed nasal bridge, hypertelorism, delayed closure of fontanelles, delayed eruption of permanent teeth, missing clavicles and wide pelvis. It runs in families; sporadic cases are rarer. Just over than 1000 cases have been reported. We are presenting here 2 cases of cleidocranial dysplasia in siblings.

Lumbar spine surgery can be performed using different anaesthetic techniques such as general endotracheal anaesthesia (GA) or spinal-based regional anaesthesia (RA). Few of the studies have been done to compare the outcomes of spinal anaesthesia versus general anaesthesia for lumbar laminectomies as both having some advantages as well as disadvantages but still it is controversial. The objective of current study is to make a comprehensive review of literature for comparing the outcomes of lumbar laminectomy performed under general anaesthesia versus spinal anaesthesia.

Literature search was performed by using PubMed, Google scholar and bibliography of related articles. To compare groups of general anaesthesia versus spinal anaesthesia, the variables focused were mean heart rate (HR), mean arterial pressure (MAP), blood loss during surgery, duration of surgery, post-operative anaesthesia care unit (PACU) time, postoperative narcotic use/pain scale, post-operative urinary retention, and post-operative nausea/vomiting.