Twelfth rib syndrome: role of intercostal blocks: case series of 10 patients

Twelfth rib syndrome (TRS) is a rare condition that causes severe pain in the loin. It is often misdiagnosed, leading to unnecessary investigations and treatments. Intercostal blocks in the 11th and 12th rib often resolve the pain for these patients. In this research paper, we aim to explore the role of intercostal block in the management of TRS based on our experience with 10 patients. Data of patients who were diagnosed with TRS were studied retrospectively from our hospital records who have been given intercostal block injection from the period of Jan 2022 to August 2023 as an audit.  Four patients underwent intercostal blocks. VAS scores were measured in follow-up for 1 and 3 months. 4 patients were lost to follow up and hence not considered in this study. The male to female ratio was 7:3. There was a statistically significant reduction in VAS score at 1 month and 3 months compared to pre-injection times. Patients who have failed conservative management for TRS can be effectively managed with intercostal block injections

Cost benefit analysis of intralesional injections in keloids using Luer lock and non-locking syringes

Background: For keloid scarring, intralesional corticosteroid injections continue to be the most often utilised first therapeutic option. This is a common procedure done on an outpatient basis by surgeons and orthopaedists. Luer lock syringes which lock the needle with syringe prevent any leakage or spillage of drug while pushing it near the keloid compared to normal syringes. Methods: We intend to do a cost benefit analysis based on the retrospective data of intralesional steroid injections done by the authors (AP and SK) in their private practice. Results: The time between 2021 to 2022, 200 injection data was retrieved, 100 each using non locking syringes and Luer lock syringes. The spillage rate with non-Luer lock syringes was 14%. Conclusions: We found that luer lock syringes prove to be cost effective after giving more than 200 injections in keloids than non-locking syringes.