To Be Or Knot To Be: A Rare Case Of Nasogastric Tube Knotting

Nasogastric tube is a commonly used medium of enteral nutrition and gastric decompression in both medical and surgical patients. Nasogastric tube knotting is a rare complication with only a handful of cases found in literature. We report a case of a functional nasogastric tube that was discovered knotted upon removal and extracted safely under sedation

Ependymal creeping on mri as a differentiating feature of high grade gliomas

Gliomas are the most common primary tumors of the brain, early and correct diagnosis of the disease is essential in improving survival. High grade lesions are associated with worse prognosis. Our study assesses ependymal creeping on MRI scans as an indicator of high grade lesions. Methodology: Preoperative MRIs of 94 cases were retrospectively reviewed for ependymal creeping. The glioma group consisted of 69 patients and 25 were in the non glioma group. Data was also analyzed separately for high grade lesions and other lesions. Results: Sensitivity of ependymal creeping for glioma vs non glioma lesions was 82.61% specificity 35.42 % (p value=0.048)c.For high grade lesions sensitivity was 67.39 % and specificity of 64.58 %( p value=0.002) Conclusion: Ependymal creeping is sensitive for identification of glial lesions but specificity is not very high. Ependymal creeping shows greater specificity for high grade glial lesions compared with other lesions and may be suggestive of diagnosis aiding in earlier recognition of such lesions, however histological conformation is needed for final diagnosis. Keywords: Ependymal creeping, MRI, high grade glioma, identificatio

Comparison of irrigation versus no irrigation during burr hole evacuation of chronic subdural hematoma

Objective: To compare the results of the use of irrigation versus no irrigation during burr hole evacuation of chronic subdural hematoma (CSDH).Methodology: The study was a retrospective chart review of those patients who underwent burr hole evacuation of CSDH during a period of 5 years. Cases were divided into two groups based on the use of irrigation during surgery. A subdural drain was placed in all patients (i.e., in both the irrigation and no-irrigation groups) and removed 24 to 48 hours postoperatively.Results: The total sample size was 56, of which 34 patients were in the irrigation group and 22 in the no-irrigation group. Recurrence rate was 17.6% in the irrigation group and 9.1% in the no-irrigation group (p = 0.46). Systemic complications were predominantly cardiac related in the no-irrigation group compared with respiratory complications in the irrigation group. The irrigation group had a mortality rate of 5.9% compared with 4.5% in the no-irrigation group (p = 0.66).Conclusion: No statistically significant difference was found between the two groups in terms of recurrence or mortality