Epidural catheter fragment entrapment: a case report

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Epidural catheters are seldom difficult to remove from patients. The breakage of the catheters is uncommon, troublesome and occasionally dangerous. "n"nCase presentation: A lumbar epidural catheter inserted in a 17 year-old man for applying anesthesia for internal fixation of femur fracture and subsequent postoperative epidural analgesia. In the third postoperative day, during unsuccessful attempt for removing the catheter, it was broken and was retained in his back. A CT- scan was performed and shows a fragment of catheter in the sub- laminar ligament between L3 and L4 without any connection with epidural space. As the patient had no complaint the fractured fragment was left in site and he was just followed up in the clinic."n"nConclusion: The knowledge of practical method in locating the retained epidural catheter, and the indication for surgical removal are very important. CT- scan is useful in showing the mechanism and locating the epidural catheter entrapment and facilitating surgical follow-up

Prevalence and Genotyping of Hepatitis D Virus among HBs Ag Positive Patients Referred to Besat Clinic, Kerman during 2012-2013

Introduction: Hepatitis D virus (HDV) is a 35 nm in diameter agent that depends on hepatitis B surface antigen in order to proliferate and accumulate. Infection with delta agent can occur spontaneously with hepatitis B virus infection and it cause acute hepatitis or develop as secondary infection in the patients with hepatitis B. Hepatitis D virus (HDV) has several genotypes based on genome sequence analysis, which shows a variety of clinical protests and geographical scope. The aim of this study was to determine the prevalence of hepatitis delta virus genotype in patients with positive HBs Ag. Methods: This cross-sectional and descriptive study was performed on 400 HbsAg-positive patients. Genotype identification was performed using polymerase chain reaction and RT-nested PCR and RFLP (Restriction Fragment Length Polymorphism). Finally sample sequencing was considered to approve RFLP gained results. Results: Among 400 patients in this study, 67 participants (16.75 %) were containing anti-HDV antibody, and it was found HDV RNA in just 7 (1.75%) serum samples. By examining the sequences using analysis of these 7 positive HDV RNA samples by restriction enzyme and MEGA4 software showed that all of them have genotype I. Conclusion: Sequence analysis of C-terminal region of Hepatitis D virus (HDV) and its comparison with other countries showed that it was the same genotype that present in countries such as Turkey, Egypt, Jordan and Pakistan. These finding indicated that there was the same origin of Hepatitis D virus (HDV) in Middle East