Care of battlefield injuries.
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Biomedical subjects
Publications and source records attributed to V Pothula.
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Repair of incisional herniae by direct approximation of the edges is associated with high incidence of recurrence. Tension free repair with prosthetic material was an advance in decreasing the incidence of recurrence. Repair with prosthetic material, to be successful, re qui res extensive dissection and its associated complications. Advances in laparoscopy along with the improvements in prosthetic materials has opened up opportunity for further decreasing the incidence of recurrence with minimal dissection.
The management of epistaxis is reviewed from ancient times onwards. Many curious methods have been employed and indeed epistaxis has been encouraged at times. Although current management is based on sound principles folklore remedies still predominate amongst some of our patients. The basis of contemporary treatments was known and practised by our ancient forbears.
A patient with metastatic melanoma of the gastrocolic ligament was rendered clinically tumor free using a minimally invasive procedure. The technique and the rationale for the procedure are reviewed.
Laparoscopic herniorrhaphy has been gaining popularity along with other minimally invasive surgical techniques. With the sophistication of instruments, evaluation of techniques and longer follow-up of patients, the outcome of such repairs is changing. Many authors are reporting a variety of techniques, complications, and results compared to conventional surgery.
Advantages of.laparoscopiC cholecystectomy (LC) in terms of shorter hospital stay, less pain, and diminished disabilrty are well documented. Less well documented are the long-term comptications of this procedure. We report a patient who developed obstructive jaundice 8 months following LC from a spilled gallstone. In our review of the literature using MEDLINE from January 1990to June 1995,we did not find this complication reported.
We have analyzed our experience with 90 consecutive patients who were operated on for parapneumonic empyema between 1981 and 1992. Patients whose empyema did not resolve with chest tube drainage were taken to the operating room. Nineteen patients had limited thoracotomy and drainage. Seventy-one patients had formal thoracotomy, debridement, pleurectomy, and decortication. We found that an age greater than 60 years, cardiac disease, end-stage renal disease, end-stage bronchitis, prolonged tube drainage, and immunosuppression are associated with increased morbidity and mortality. In those patients who do not respond well to a short course of chest tube drainage, we recommend early aggressive surgical approach, including formal thoracotomy and definitive treatment. This allowed for early discharge from the hospital without chest tubes or open draining wounds. In extremely ill patients, limited thoracotomy may be all that is safe or possible and usually suffices.
Benign cystic teratomas are asymptomatic in many cases. There are some reports of production of thyroid-stimulating hormone, estrogen, testosterone, and prolactin by these tumors. This article reports a patient in whom a twisted cystic teratoma simulated ruptured ectopic pregnancy by beta human chorionic gonadotropin production and hemorrhage into the peritoneal cavity.
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