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Kumaravel S.,Thanjavur Medical College | Balamurugan J.,National Pharma Hospital and Research Institute | Padmanaban K.G.,Diagnostic Center
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2014

We report a case of gastric carcinoma which presented mainly with vague limb symptoms. 35 year old housewife had pain in her both thighs for two months duration. She was thin built and moderately nourished; had slow waddling gait; had no tenderness on the spine or lower limbs. Her lumbosacral spines X-ray had diffuse mottling of all the bones of the pelvis and spine. She had thrombocytopenia, leucocytosis, bicytopenia with polymorpho leucocytosis and atypical normoblastosis. Her MRI of all the vertebrae, sacrum, pelvis and visualized femur bilaterally suggested diffuse metastases. Ultra sonogram of abdomen and pelvis showed irregular thickening of the stomach wall, along the proximal body, fundus and cardia of the stomach. There was involvement of liver, ovaries adnexa. From the above thickened site of stomach, which was suspected to be a possible primary lesion, a biopsy was obtained, by oesophago gastro duodenoscopy. This was reported as an ulcerated gastric mucosa with underlying diffuse sheets of neoplastic cells. Some signet ring appearance consistent with a poorly differentiated diffuse type of adenocarcinoma of stomach. This case of gastric carcinoma presented with indistinct musculoskeletal symptoms to an orthopaedic surgeon. One cannot afford to miss and dismiss any vague diffuse pain without investigating. Source


Kumaravel S.,National Pharma Hospital and Research Institute
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

For effective rehabilitation of fractured limb, a functional limb is needed till the time of fracture union. If due to any reason, the limbs are lost either below the fracture site or in the contra lateral limb, then rehabilitation is a serious problem. This paper presents cases with simultaneous loss of ipsilateral and contra lateral limbs in the same accident which warranted special care to make the patients ambulate and the fractures to unite. Source


Shanmugasundaram K.,Government Thanjavur Medical College | Shanmugasundaram K.,National Pharma Hospital and Research Institute
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

Shoulder injuries are usually identified and treated with regular X-rays. Occasionally there is every chance that some fractures are missed if not carefully looked for. We present one rare fracture in shoulder which was identified and treated. CT scan of the shoulder help in difficult situations. The paper reports a rare type fracture of superior border of scapula. Source


Kumaravel S.,Government Thanjavur Medical College | Victor J.,National Pharma Hospital and Research Institute
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

Ruptures of triceps tendon are rare. There can occur due to a fall on an outstretched hand or direct contact injuries. Among muscle and tendon injuries triceps injury and that too open injuries are rare and hence there is no fixed treatment protocol. A case of an open triceps rupture associated with comminuted fracture of humerus is presented with emphasis on the material for reconstruction of the ruptured triceps is presented. Source


Kumaravel S.,Government Thanjavur Medical College | Kumaravel S.,National Pharma Hospital and Research Institute | Muruganantham R.,National Pharma Hospital and Research Institute
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2014

Lesions of lower limbs in middle aged or old adults with medical problems like elevated renal parameters pose a challenge to surgeons. This is because of anaesthetic risks or local factors causing increased chance of torrential bleeding. In such patients, the need is immediate mobilization to avoid recumbency. Three diabetic males (two under 60 and one 79 years old) with elevated renal parameters presented to us. They had acute bi-malleolar fracture, acute fracture of the lower third shaft of femur and fibrous dysplasia of proximal femur. Of these three, one was on hemo-dialysis, while the remaining two were incidentally found to have contracted kidneys and elevated renal parameters. Deformed Pagetic femora are more prone for non union and have more chance of intra-operative bleeding with more mortality. Same is the case with fibrous dysplasia where torrential intra operative bleeding is expected from the lesion. In general renal patients have more risk of death. Their reduced excretory function cause high blood urea nitrogen, creatinine, acid, potassium, salt, and water. They also have additional likelihood of intra operative bleeding and post operative infection. To mobilize such poor risk patients, a custom made weight-relieving orthosis is made with its upper end molded to support the inferior aspect of the ischial tuberosity. This relieves the injured part or lesion from loading during the stance phase. The patients were allowed mobilization as an when they wanted. Thus this orthosis was useful especially in individuals whose results of anaesthesia and surgery on the affected bones are uncertain where one requires early mobilization. Source

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