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Garg P.,Fortis Super Specialty Hospital | Garg P.,MM Institute of Medical science and Research | Garg M.,Indus Super Speciality Hospital | Menon G.R.,Indian Council of Medical Research ICMR
Colorectal Disease | Year: 2013

Aim: A systematic review was carried out to analyse continence at 2 years or more after lateral internal sphincterotomy (LIS) for chronic anal fissure (CAF). Method: PubMed, MEDLINE, Scopus, Embase, Ovid, SCI, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar were used to search the literature from 1969-2012 for studies reporting a follow-up of more than 2 years after LIS for CAF. The primary outcome parameter analysed was continence. The secondary outcome parameters included success rate, recurrence, incidence of postoperative abscess and fistula formation and patient satisfaction. Results: Of 324 studies screened, 22 (n = 4512) were included. The mean follow-up period ranged from 24-124 months. The overall continence disturbance rate was 14% (95% CI 0.09-0.2). Weighted analysis showed flatus incontinence in 9% (95% CI 0.04-0.16), soilage/seepage in 6% (95% CI 0.03-0.1), accidental defaecation in 0.91% (95% CI 0.003-0.02), incontinence to liquid stool in 0.67% (95% CI 0.001-0.02) and incontinence to solid stool in 0.83% (95% CI 0.003-0.02) of patients. Conclusion: The long-term risk of continence disturbance after lateral internal sphincterotomy is significant. Randomized controlled trials with a long follow-up are needed to substantiate these findings and to redefine its role in the treatment of chronic anal fissure. © 2013 The Association of Coloproctology of Great Britain and Ireland.

Chaudhry M.,MM Institute of Medical science and Research
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2012

We report a case of an epithelial inclusion cyst of the iris following cataract surgery that was successfully treated with en bloc excision, after an unsuccessful attempt with Neodymium-doped Yttrium Aluminium Garnet (Nd YAG) Laser. A 60-year-old man had undergone cataract surgery two years back. One year later, he developed a pigmented epithelial inclusion cyst of the iris which progressively increased in size. His vision reduced to finger counting close to face as the cyst grew over the pupil. We performed Nd YAG laser cystotomy of the cyst wall initially, but the treated lesion recurred. So we performed an en bloc iris excision of the cyst with sector iridectomy. There was no recurrence as determined by slit lamp examination at six months after treatment. Hence, we conclude that en bloc excision can be used to effectively treat epithelial inclusion cyst of the iris. © NEPjOPH.

Singh R.,MM Institute of Medical science and Research
Annals of African Medicine | Year: 2014

Occurrence of solitary intramuscular cysticercosis without involvement of the central nervous system is rare. We report a case of solitary cysticercosis of the brachioradialis muscle in a 35-year-old woman who presented with discomfort and pain in the right elbow and arm after trivial trauma. There were no systemic or neurological features.

Agrawal A.,MM Institute of Medical science and Research
Journal of Surgical Technique and Case Report | Year: 2011

Cranioplasty is a common, but formidable surgical procedure for neurosurgeons, in patients with scalp and / or calvarial defects. This procedure can be simple or complex. The main objectives of cranioplasty are: To achieve primary wound healing, obliterate dead space, and seal off sterile cranial areas from contaminated oronasal cavities, to restore the normal barriers protecting the intracranial structures (together with a satisfactory cosmetic result) and obtain a permanent or very durable reconstruction, using biologically inert materials, and also to restore the aesthetics. The greatest problem is selecting the optimum material for repair of the cranial defect. Many synthetic substitutions of the dura and bone are often used for reconstruction of the skull base; unfortunately, these methods bear significant disadvantages and can induce chronic inflammation, carry a high risk of infection, and are inferior to biological sources in terms of strength and sealing quality [with the exception of some materials, such as titanium mashes and CortossTM (Orthovita® , Malvern, USA), which are seen to have more strength than the thin split thickness calvarial bone]. The primary aim of this article is to review the basic principles to use the split calvarial graft for the reconstruction of the skull defect.

Chaudhry M.,MM Institute of Medical science and Research
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2011

Posterior capsular opacification, also known as after cataract develops in 33 % of patients after uneventful cataract surgery. Nd-YAG Laser capsulotomy is the treatment of choice for PCO and is routinely performed by the general ophthalmologist on an OPD basis. Endophthalmitis, although a rare complication after Nd-YAG Laser capsulotomy, has been reported in the literature. We report a case of Propionibacterium acnes endophthalmitis following laser capsulotomy and the possible mechanism of its occurrence. © NEPjOPH.

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