Primary hydatid cyst of erector spinae muscle of upper back

Hydatid disease is a zoonosis caused by an infection with the larvae of the tapeworm Echinococcus granulosus, it mostly involves liver and lungs but it may exceptionally affect muscle. We report the case of a 29 years old man who was admitted to our surgical clinic with a primary hydatid cyst in erector spinae muscle of upper back diagnosed by clinic examination, imaging and serological testing. The treatment was a complete pericystectomy and chemotherapy by antiparasitic drugs. Hydatid disease is an endemic disease in sheep-producing regions. In human, this disease involves usually the liver and the lungs and exceptionally the muscle. The diagnosis may be challenging, as it should consider arguments such as history, physical examination, imaging and serological testing. The best treatment is pericystectomy with perioperative chemotherapy to reduce risk of occurrence. The hydatid cyst of erector spinae muscle is exceptional even in endemic area, the diagnosis may be challenging and the surgery is the gold standard of treatment

Assessment of bacteriological profile and wound infection in open and laparoscopic gall bladder surgery

Background: Cholecystectomy is one of the most frequent types of abdominal surgery performed in the world. Generally, there is minimal risk of serious postoperative complications. One of the complications is Surgical Site Infection, which can be caused by bile leakage and intraoperative contamination. Methods: This prospective study was conducted in department of General Surgery, SKIMS medical college Srinagar, from June 2020 to July 2023 comprising of 100 patients. All patients undergoing the procedure were observed for wound infection. Results: A total of 100 patients were studied with female to male ratio of 2:3. The mean age was 50.24±12.25 with 54% elderly patients. The average hospital stay was 4.02±07. 88% subjects belonged to ASA II Category with Hypertension and hyperthyroidism as common comorbidity. 11 patients got wound infection including 9 from open cholecystectomy and 02 from laparoscopic cholecystectomy with most patients belonging to elderly age group. Wound culture was positive in 9 out of 11 subjects of open cholecystectomy. E. coli was seen to be a major causal bacterial agent. Bile culture was positive in 8 patients. Both genders were almost equally affected by wound infection. Meropenem, Ceftriaxone, Gentamicin and Amikacin showed the highest number of antibiotic sensitivities tested in case of wound cultures. Conclusions: The prevalence of positive wound culture in uncomplicated laparoscopic cholecystectomy is low as compared to open procedure. Elderly age, co-morbid patients, patients who had history of jaundice, recent history of cholecystitis were at higher risk of wound infections

Short term results of a single autologous whole blood injection for treatment of resistant tennis elbow

Background: Lateral epicondylitis commonly called tennis elbow is a common cause of elbow pain and involves degeneration of common extensor origin with no unanimously supported algorithm for the treatment. Recently, autologous blood injection has been reported for the treatment of resistant cases. We present the short term results of a single shot of autologous whole blood for the treatment of resistant tennis elbow.Methods: The study was conducted on 56 patients who fulfilled the other inclusion criteria’s. 2 ml of autologous whole blood was introduced just proximal to the lateral epicondyle and the contents were injected on the under surface of the extensor carpi radialis group of muscles. Pain severity using VAS and Nirschl Staging was assessed before injection and re-evaluation was done at 4 weeks, 12 weeks and 6 months.Results: Before the procedure average pain score was 7.5(range 5-9). The average Nirschl stage was 5.5 (range 4-7). After autologous blood injections the average pain score decreased to 4 at 4 weeks, 2.8 at 12 weeks and 2.5 at 6 months. The average Nirschl stage decreased to 3.53 at 4 weeks, 2.45 at 12 weeks and 2.3 at 6months. The reduction was statistically significant (p<0.001). 28 out of 56 patients (50%) were completely relieved of pain with a pain score of 0 at 6 months. There was no major complication.Conclusions: A single injection of autologous whole blood for resistant tennis elbow is an economical and effective treatment and has an excellent safety profile

Elastic nailing of the femoral fractures in the 6-10 year age: a study from Kashmir

Background: Fractures of the femur are amongst the most common paediatric orthopaedic injuries. The aim of this study was to assess the efficacy of the stainless steel elastic nail in the management of these fractures in the 6-10 year age group.Methods: Fifty patients in the age group of 6-10 years with displaced diaphyseal femoral fractures were stabilized with these nails. Patients were followed up clinically and radiologically for a minimum period of 1 year.Results: There were 64% excellent and 34% satisfactory results. 2% patients had poor result.Conclusions: These nails are a relatively easy to use, minimally invasive, physeal-protective implant system with high rate of satisfactory and excellent outcomes in children aged 6-10 years

Evaluation of phytochemical, antioxidant, and In-vitro antidiarrhoeal, activity of Euphorbia hirta

Background:  The current study was carried out to evaluate the phytochemical, antioxidant, and In-vitro antidiarrheal properties of Euphorbia hirta Methods: Extracts were obtained using cold extraction, hot extraction and autoclave extraction methods using Methanol, Chloroform, Petroleum ether and distilled water as solvents. Crude extracts were screened for different phytochemical constituents like sugars, saponins, flavonoids, tannins, and glycosides etc. Antioxidant activity was evaluated using spectrophotometric method. The in-vitro antidiarrheal activity was elucidated by the antimicrobial activity using agar diffusion method. Results: Methanol proved to be a good solvent for extraction. In-vitro antidiarrheal activity was shown by all extracts on Escherichia coli, Staphylococcus aureus, and Salmonella typhi bacteria which are mainly responsible for diarrhea. Conclusion: From the phytochemical screening it shows presence of phytochemicals like alkaloids, tannins, glycosides, and saponins. The plant also shows antioxidant activity, methnolic extracts shows higher activity and it shows In-vitro antidiarrhoeal activity which clearly indicates that the plant can be used for the treatment of diarrhea. Further studies should be done to isolate the compound responsible for activity in the experimental animals. Keywords: Euphrobia hirta, autoclave extraction, antidiarrheal, phytochemicals

Traumatic diaphragmatic rupture, a diagnostic dilemma in the presence of eventration: a case report

Eventration of the diaphragm is the condition where the muscle is permanently elevated, but retains its continuity and attachments to the costal margins. Traumatic diaphragmatic rupture is a recognized consequence of high velocity blunt trauma to the abdomen usually a result of motor vehicle accident. Multi-slice CT and Magnetic Resonance Imaging in the pre-operative evaluation of trauma patients, diaphragmatic rupture can be still overlooked if not evaluated with the fair degree of clinical suspicion, more so if it is associated with an eventration of diaphragm - as was in our case

Case Report-Variant of Vohwinkel's syndrome

A 28-year-old female born to consanguineous parents, presented with progressive palmoplantar keratoderma since the age of six months and a constricting band on right fourth finger of one year duration. There was history of similar complaints being present in two other family members. Associated clinical findings included starfish-shaped cornified plaques on knuckles, resorption of distal phalanges and keratotic plaques on elbows, groins and knees. The patient was mentally sound and had normal audiometry. Biopsy from hyperkeratotic plaque showed hyperkeratosis, parakeratosis, increased granular layer and papillomatosis. Gene mapping for loricrin mutation was found to be negative