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Evaluation of liver biochemical problem between COVID-19 patients using liver organ cirrhosis versus COVID-19 on it's own and also hard working liver cirrhosis alone: The STROBE observational study.
Most studies regarding the use of locking condylar plates in distal femoral fractures have been carried out in tertiary centres. The aim of this case series was to examine outcomes for patients managed in a rural setting and to answer the question 'should we be shipping these patients out to a regional trauma centre?' Recent insertions of condylar locking compression plates (LCPs) at a rural district general hospital were examined. (All used the Synthes LCP Condylar Plate 4.5/5.0 periarticular plating system). Their clinical records and radiology were reviewed to identify failure rates and facilitate discussion of such cases. Of 36 reviewed cases, 4 instances of failure were identified (11%), and their cases are discussed individually herein. This review not only affords the opportunity to discuss cases of failure and to speculate upon their potential causes, but also highlights reassuringly high quality of outcomes for these patients outside of larger teaching hospitals.Abdominal complications after placement of ventriculoperitoneal (VP) shunt are commonly reported but asymptomatic bowel perforation with enterocutaneous fistula (ECF) is rare. This case describes a young male patient who underwent VP shunt for hydrocephalus 10 years ago. He presented with ECF due to the non-functioning abdominal end of the shunt. Patient was managed with laparotomy with fistulectomy with bowel resection and anastomosis. Sirtinol ECF is a rare complication of VP shunt.Trocar-site hernia is an uncommon complication of laparoscopic surgery and can be classified as early-onset, late-onset or special type. Special type hernias usually occur in the early postoperative period and result in evisceration of intra-abdominal contents through all layers of the abdominal wall without an overlying hernia sac. We present a case of special type herniation of the appendix through a 5-mm trocar site in the right iliac fossa following laparoscopic repair of a perforated duodenal ulcer. In this case, herniation occurred after removal of a drain inserted through the trocar site intraoperatively and was treated with emergent open appendicectomy. A number of patient and technical factors may be associated with an increased risk of trocar-site herniation including increasing age, elevated body mass index, increasing trocar size, longer procedure duration and absence of fascial closure. These factors must be borne in mind when planning trocar placement and number to reduce the risk of herniation.A report of true aneurysms is extremely rare. There are only five previous case reports of true aneurysm of the facial artery. In the previously reported cases, there was no case that underwent trapping and surgical excision. In this case report, we describe the procedure of internal trapping before the surgical excision of a huge true aneurysm of the right facial artery for a 79-year-old woman. There was no recurrence of the aneurysm during a 6-month follow-up period.Trigeminal schwannoma is the second most common schwannoma after vestibular schwannoma. Symptoms vary depending on the anatomical structures affected by the tumor, including facial pain, paresthesia, dizziness and ataxia. The primary goals are controlling the symptoms and the maintenance of cranial nerves' integrity perioperatively. We report a 39-year-old lady who was complaining of mild right-sided headache, vision and hearing loss, right facial weakness and dysphagia. CT and MRI showed a large dumbbell-shaped tumor originating from the trigeminal fossa abutting the petrous and cavernous carotid artery and extending to the infratemporal fossa. An image-guided endonasal endoscopic removal was successfully done. Image-guided endonasal endoscopic removal of a trigeminal schwannoma abutting the petrous and cavernous carotid artery and extending to the infratemporal fossa is a safe, effective approach, as it offers excellent visualization, accurate localization and safe dissection of the tumor from the critical anatomical neurovascular structures surrounding it.We present two cases of acute arterial thrombosis in patients who were confirmed to be SARS-CoV-2 positive. Neither of the patients had a background of underlying vascular morbidity. At the time of presentation, both patients exhibited only mild respiratory symptoms of COVID-19. After initial assessment and work-up, both patients underwent surgery for their respective vascular pathologies. They both did well post-operatively and were discharged home. This is an unusual presentation of acute arterial thrombosis in two patients with only mild symptoms of COVID-19 infection.Meckel's Diverticulum is a sac-like protrusion of the intestinal wall. It is located at 40-60 cm from the caecum. In the majority of cases, Meckel's Diverticulum is clinically silent, while complications are found in 4% of the population. Complicated diverticulitis is associated with the formation of abscess, fistula, bowel obstruction or frank perforation. We present a case of a 63-year-old woman with a distended abdomen, pain in the lower right abdominal quadrant, fever 37°C and where emergency exploratory laparotomy revealed that obstruction was caused by a bowel loop trapped by a mesenterium-diverticular band.Intussusception occurs when one portion of bowel 'telescopes' into another due to a lead point created by a range of benign or pathologic process. Intussusception mostly occurs in children. Although adult intussusception (AI) is rare, accounting for less then 5% of intestinal obstructions, it is more concerning in adults as malignancy accounts for nearly 65% of lead points in AI. Patients present with severe abdominal pain concerning for an acute abdomen along with a degree of bowel obstruction. We have experienced a total of 11 patients within recent years presenting with symptoms of an acute abdomen due to AI. None of these patients were found to have a pathologic process creating a lead point. However, we found that all of them were marijuana users. In this report, we compare their management, hospital course and review of the literature discussing proposed mechanisms that suggest an association between cannabis and intussusception.
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