- Effect of Low-Level Laser Therapy versus Electroacupuncture on Postnatal Scanty Milk Secretion: A Randomized Controlled Trial. [Journal Article]
- AJAm J Perinatol 2019 Jul 21
- CONCLUSIONS: Electroacupuncture is more effective than low-level laser therapy in increasing postnatal scanty milk secretion.
- Ischemic pancreatitis with infected walled-off necrosis with a colonic fistula after cardiopulmonary bypass successfully treated by endoscopic ultrasound-guided drainage. [Journal Article]
- CJClin J Gastroenterol 2019 Jul 20
- A 72-year-old man who had been on continuous ambulatory peritoneal dialysis treatment for 10 years underwent cardiopulmonary bypass for aortic valve replacement due to aortic valve stenosis. After su…
A 72-year-old man who had been on continuous ambulatory peritoneal dialysis treatment for 10 years underwent cardiopulmonary bypass for aortic valve replacement due to aortic valve stenosis. After surgery, he experienced pancreatitis, and rupture of a splenic artery aneurysm. He went into cardiopulmonary arrest but was successfully treated by transcatheter arterial embolization (TAE) with cardiopulmonary resuscitation. At three weeks after TAE, CT showed heterogeneous enhancement and the accumulation of pancreatic fluid in the pancreatic tail. At 4 months after TAE, he had sepsis and CT showed greater fluid collection with emphysema in comparison to 3 months previously. We diagnosed infected walled-off necrosis (WON). Conservative therapy with antibiotics was not sufficiently effective; thus, we performed endoscopic ultrasound-guided drainage (EUS-D). Contrast imaging revealed WON with colonic fistula. The WON remarkably decreased in size on CT after EUS-D. We experienced a rare case of ischemic acute pancreatitis (AP) caused by cardiopulmonary bypass complicated with infected WON with a colonic fistula. Ischemic AP more frequently shows a severe course with a fatal outcome in comparison to AP of other causes. However, in our case, ischemic AP with infected WON was successfully treated by EUS-D despite the presence of a WON with a colonic fistula.
- Diagnosis and management of traumatic bilateral chylothorax: a clinical conundrum. [Journal Article]
- BCBMJ Case Rep 2019 Jul 19; 12(7)
- A 35-year-old man was admitted in the emergency department with a complaint of progressive dyspnoea and 4-day prior history of a road traffic accident. An initial evaluation was inconspicuous and he …
A 35-year-old man was admitted in the emergency department with a complaint of progressive dyspnoea and 4-day prior history of a road traffic accident. An initial evaluation was inconspicuous and he was discharged. Clinical examination and radiological imaging suggested bilateral pleural effusion for which bilateral intercostal drains were inserted. Further pleural fluid analysis aided the diagnosis of bilateral chylothorax. A conservative approach consisting of a fat-free diet, total parenteral nutrition and octreotide therapy was started. Upon failure of conservative management, thoracic duct ligation by thoracotomy was done. Chylous output decreased dramatically and subsequently, and the patient was discharged in a healthy condition. This case illustrates intricacies involved in the diagnosis and management of traumatic chylothorax. Also, conservative treatment forms the first line of management, but if ineffective, then early surgical intervention should be considered. Early diagnosis and timely intervention are keystone factors for a better outcome.
- Therapeutic effects of ranibizumab in patients with polypoidal choroidal vasculopathy. [Journal Article]
- BOBMC Ophthalmol 2019 Jul 19; 19(1):153
- CONCLUSIONS: Three monthly injections of ranibizumab as an initial treatment could significantly improve VA in PCV patients in the short term. At 12 months postinjection, ranibizumab treatment could stabilize VA in most PCV patients. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were predictive factors for the relative improvement of VA at the final follow-up.
- HIV - Old Foe with a New Face. [Journal Article]
- JAJ Assoc Physicians India 2018; 66(8):93-95
- We report a case of a middle aged seropositive male, virologically well suppressed on second line ART (Anti-Retroviral therapy) who presented with a subacute history of neurological symptoms. On imag…
We report a case of a middle aged seropositive male, virologically well suppressed on second line ART (Anti-Retroviral therapy) who presented with a subacute history of neurological symptoms. On imaging and CSF (cerebrospinal fluid) evaluation, he was found to have CD8 encephalitis - a new, rare but treatable entity. To the best of our knowledge, no case has been reported from India.
- Biological response to peri-implantitis treatment. [Journal Article]
- JPJ Periodontal Res 2019 Jul 18
- CONCLUSIONS: Elevated concentrations of IL-1β in PICF were consistent with PIP. A decrease in MMP-8 concentration in PICF at three months after treatment is consistent with a healing biological response.
- Targeted Transforaminal Epidural Blood Patch for Postdural Puncture Headache in Patients with Postlaminectomy Syndrome. [Case Reports]
- CRCase Rep Neurol Med 2019; 2019:1968314
- Postdural puncture headache is a leak of cerebrospinal fluid that lowers intracranial pressure and usually presents as a positional headache. If conservative treatments are not successful, the epidur…
Postdural puncture headache is a leak of cerebrospinal fluid that lowers intracranial pressure and usually presents as a positional headache. If conservative treatments are not successful, the epidural blood patch is the gold standard of the treatment for dural puncture. The interlaminar approach is the most commonly used technique for an epidural blood patch. This case report describes a patient who was treated with a transforaminal epidural blood patch for postdural puncture headache following an acupuncture procedure on his lower back after two epidural blood patches using an interlaminar approach had failed. The patient underwent an acupuncture therapy for management of chronic low back pain due to postlaminectomy syndrome. After the procedure, the patient had a severe headache and the conservative treatment was not effective. The two interlaminar epidural blood patches at the L2-3 level and at the L3-4 level were failed. We performed transforaminal epidural blood patch at the L3-4 and L4-5 levels on the left side, the site of leakage in the MRI myelogram. His symptoms finally subsided without complication. This case demonstrates that targeted transforaminal epidural blood patch is a therapeutic option for the treatment of postdural puncture headache when epidural blood patch using an interlaminar approach is ineffective.
- Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome. [Journal Article]
- SJScand J Trauma Resusc Emerg Med 2019 Jul 18; 27(1):68
- CONCLUSIONS: The use of PPD at the onset of compression release is beneficial for renal protection and survival outcome in a rabbit model of CI.
- Multiplex PCR of bronchoalveolar lavage fluid in children enhances the rate of pathogen detection. [Journal Article]
- BPBMC Pulm Med 2019 Jul 18; 19(1):132
- CONCLUSIONS: Compared to conventional culture, the use of the SF assay on the BAL of children with pneumonia increases pathogen detection rates and therefore adds important information to guide anti-infective therapy.
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- Hypotension within one-hour from starting CRRT is associated with in-hospital mortality. [Journal Article]
- JCJ Crit Care 2019 Jul 08; 54:7-13
- CONCLUSIONS: Hypotension occurs frequently in patients receiving CRRT despite having a reputation as the dialysis modality with better hemodynamic tolerance. It is an independent predictor for worse outcomes. Further studies are required to understand this phenomenon.