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Harsh Rajeev Mehta*, Payal Salvi1, Sarojini P Jadhav and Suresh R Harbade

DOI : 10.32474/GJAPM.2020.03.000151

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Lipomas are the most common mesenchymal tumours. They arise from primordial adipocytes and gradually increase in size with age. They usually develop as well-circumscribed, encapsulated masses that are freely mobile beneath the skin. Lipomas can occur in many locations all over the body, but most commonly in the subcutaneous tissue of the head, neck, shoulders and back. Lesions that are larger than 5 cm are termed as giant lipomas [1]. Giant lipomas of the upper extremity are rare and require an appropriate workup. This should be followed by adequate open surgical excision and repeat examination over time to monitor for recurrence...... ReadMore

Miranda Nava Gabriel*, Gallo Frias Luis Gilberto, Pimentel Diaz Alejandro Yami and Ginger Ramirez Diana Guadalupe

DOI : 10.32474/GJAPM.2020.02.000150

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Mucoepidermoid carcinomas are rare and comprise 5% of head and neck malignancies and are seen in 2.6 cases for every 100,000 people. We report the case of a 49 year old blacksmith from Guadalajara, Mexico who presents to office and who is later diagnosed with a mucoepidermoid carcinoma located in the left side of the submandibular gland, tumor was treated with two surgery for removal of the mass with patient now being seen under periodic moments..... ReadMore

Yasser Mohammed Hassanain Elsayed*

DOI : 10.32474/GJAPM.2020.02.000149

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Rationale: Serum potassium concentration is usually elevated in the cases of diabetic ketoacidosis. Coronary artery spasm is recognized after the hematological chemical disturbance. Hyperkalemia is a rare cause of junctional tachycardia. Insulin decreases potassium levels in the blood by redistributing it into cells via increased sodium-potassium pump activity.Patient concerns: A young housewife female patient presented to the emergency department with diabetic ketoacidosis, coronary artery spasm, and junctional tachycardia. Diagnosis: Hyperkalemia-induced coronary artery spasm and junctional tachycardia in diabetic ketoacidosis. Interventions: Electrocardiography, oxygenation, central venous pressure monitoring, and echocardiography. Lessons: Electrolytes disturbance especially hyperkalemia is a significant serious..... ReadMore

Eman M Kamal Abo Seif, Walid Y Kamel and Amr M Hilal Abdou*

DOI : 10.32474/GJAPM.2020.02.000148

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Background and Aim: Breast surgeries are associated with post-operative pain and restricted shoulder mobility, so the aim of this study is to assess the analgesic efficiency and safety of Continuous Pectorals II (PECS) block by adding magnesium to bupivacaine as an adjuvant versus bupivacaine as a sole agent in cases of simple mastectomy. Patients and Methods: This randomized double blinded study designed to compare the analgesics efficacy and safety of continuous PECS II using bupivacaine versus continuous PEC II using bupivacaine plus magnesium in patients undergoing simple mastectomy and postoperative period. We enrolled 40 adult females ASA I-II patients’ candidates for simple mastectomy without axillary clearance. All patients were randomly distributed into two groups. Control group: prior to surgica..... ReadMore

Jbili N*, Bibiche L, Jebbar N, Maaroufi A, Diai A, Chkoura K, Kechna H and Laoutid J

DOI : 10.32474/GJAPM.2020.02.000147

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We report the observation of a 56-year-old female patient, with no specific medical history, operated on for acute cholecystitis. One week after the intervention, she presented a fatal fulminant hepatitis in less than two weeks, associating a deterioration of the general state with jaundice cutaneous mucosal frank, cytolysis and cholestasis important in addition to a deep hypo albuminemia and a very low prothrombin level. The toxicity of halothane has been incriminated due to the negativity of the etiological balance. Like the literature and this clinical case, the still frequent use of halothane in several countries must be reviewed...... ReadMore

Jamal Hasoon*, Amnon AB, Ivan Urits, Vwaire Orhurhu, Omar Viswanath

DOI : 10.32474/GJAPM.2020.02.000146

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Spinal epidural abscess (SEA) is a rare suppurative infection of the spinal cord. SEAs are formed in the true spinal epidural space between the dura and vertebral wall. They are the result of direct spread from adjacent structures, hematogenous spread or iatrogenic inoculation of bacteria into the spinal canal...... ReadMore

Bonilla Castillo Luis*, Pérez Herrero, María A and Abad Anna

DOI : 10.32474/GJAPM.2020.02.000145

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Surgery has a very important role in solid tumors multimodal treatment. The primary excision can be curative itself or can be combined with neoadjuvant or adjuvant chemotherapy and / or radiotherapy. Despite therapy advances, recurrence and metastases appear as an important source of morbidity and mortality in cancer patients. There is a huge growing interest in events related to surgery and the perioperative period that not only help to release cancer cells into general circulation, but also facilitate its growing, leading to regional recurrences and metastases. Data obtained from laboratory and animal experimentation suggest that anesthetics drugs may affect long-term results after cancer surgery...... ReadMore

Andrew Hague

DOI : 10.32474/GJAPM.2020.02.000144

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Stopping pain is now much easier and no drugs are used. Doctors are believing what they see even though they may not fully understand how they caused the cure. Reports on the pancreas from opposite sides of the world; diabetes and cancer. A simple diagnosis for cancer is explained...... ReadMore

Melody H Long* and Tracy YS Tan

DOI : 10.32474/GJAPM.2020.02.000143

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Pectoralis Nerve (PECS) block was first described as an alternative to thoracic epidural and paravertebral blocks in managing pain after breast surgery [1]. Since then, there have been modifications such as the PECS II block and expansion of its uses to include analgesia for Port-a-Cath insertion and removal [2], minimally invasive cardiac surgery [3] and cardiac resynchronization therapy (CRT) device implantation [4]...... ReadMore

Ayse Veyhurda Dikmen*

DOI : 10.32474/GJAPM.2020.02.000142

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I aimed to define the efficacy of silodosin in treatment of lower urinary tract symptoms of men and form a background for a nomogram for Turkish population. Materials and Methods: Responses of treatment of 1600 male patients attending outpatient urology clinic with lower urinary tract symtoms between March 2013 and March 2019 were evaluated retrospectively. The patients were between 41 and 97, mean age of whom was 63,1±2,3 with serum total PSA level being under 4ng/dl and benign digital rectal examination findings, none of them, getting any α-blocker for at least one month by the time of outpatient clinic attending. The patients who have been treated with silodosin for 9 months due to benign prostatic hyperplasia (BPH) were evaluated retrospectively with their pretreatment and posttretment results of Qmax (maximum flow rate), IPS..... ReadMore

Sabri A Soltan*, Hesham S Abdelraouf and Mahmoud M Alsagheir

DOI : 10.32474/GJAPM.2020.02.000141

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Background: Adequate analgesia post-operative is crucial to permit early mobilization and effective cough in order to decrease the respiratory system issues and complications. The usage of peripheral nerve blockage in conjunction with sonographic technology and neural stimulators have resulted in better fascial planes identification. Aim: To compare the analgesic effectiveness of sonographic -guided caudal epidural blockage versus sonographic -guided single-shot thoraco-lumber paravertebral blockage in pediatric cases undergoing lower abdominal surgeries such as herniotomy. Methodology: This is a prospective randomized interventional clinical research trial performed in Department of Anesthesiology, Samir Abbas Hospital ‘Saudi Arabia to compare single-shot caudal Blockage to single-shot paravertebral blockage conducted on sixty p..... ReadMore

Sushanta*

DOI : 10.32474/GJAPM.2019.02.000140

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A 70-year-old female presented with gradual onset dyspnea with moderate exertion for 6 months. She had history of stroke 1 month back which was resolved. On 2D echo she had a mass in LA (1.6×1.6cm) with base attached to IAS adjacent to AML. On coronary angiography she had lesion in LAD with 60-70% stenosis. But intraoperative TEE revealed mass in left ventricle attached to PML undersurface. The operation was performed, CABG with LIMA to LAD grafting & transannular decompression of the LV mass performed. Surgery done uneventfully. The cyst content consists of necrotic sebaceous-type material with calcification. Histopathology of excised material revealed it to be a foregut cyst of myocardium. The patient had an uneventful postoperative course and was discharged in good clinical condition...... ReadMore

Behzad Saberi*

DOI : 10.32474/GJAPM.2019.02.000139

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Monitoring the patients during neurosurgical operations, plays an important role to get best surgical results. Central venous pressure and arterial pressure monitoring are important in specific neurosurgical operations [1]. ICP monitoring during neurosurgical approaches, is also of importance in some neurosurgical approaches. Cerebral oxygenation monitoring, jugular venous oximetry, motor and somatosensory evoked potentials, transcranial and precordial Dopplers and electromyography are some neuromonitoring techniques which can be used based on the patient’s condition and requirements for specific neurosurgical operations [2-4]..... ReadMore

Ayse Veyhurda Dikmen*

DOI : 10.32474/GJAPM.2019.02.000138

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Introduction & Objective: Stress urinary incontinence is a psychologically devastating disturbance, affecting the incontinent population mainly of elderly women. we aimed to identify retrospectively the response rate of the patients to minimal invasive treatment via bladder neck injection with bulking agents for primary bladder neck insufficiency through a new look. we aimed to make urologists remember this non-invasive method for stress urinary incontinence since it is a devastating problem, which can even stop sexual life completely for the elderly female population. Methods: 4200 female patients attended our urology clinic with symptoms of stress urinary incontinence between January 2014 and April 2019 and underwent urologic evaluation and diary for daily-used pad number. 81 of 4200 patients were excluded during the period of co..... ReadMore

Sakraoui R*, Habchi N, Bekralas H, Bouallag M, Ziane H, Maouche H and Guerinik M

DOI : 10.32474/GJAPM.2019.02.000137

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A polytraumatized patient is a victim of violent trauma. Objective: to evaluate the management of polytrauma patients after describing their epidemiologic characteristics and to individualize the predictive factors of mortality. Materials and Methods: This is a prospective and descriptive study on the observations of 147 polytrauma patients admitted to the medical and surgical emergency department of the University Hospital Center Mustapha Pacha between June 2011 and June 2013. We have not included in the final examinations of the present, but the half-way to the vital prediction for the clinical, biologic, therapeutic and epidemiological aspects of each patient admitted for polytrauma...... ReadMore

Divya R* and Ashok V

DOI : 10.32474/GJAPM.2019.02.000136

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Tea is a beverage made from the infusion of the leaves of Camellia synesis. A number of bioactive products such as theanine,tea polyphenols (TPP) and tea polysaccharides (TPS) are extracted from Tea. Studies show that the TPS acts as an antioxidant, antiinflammatory agent, anticancer, antihyperglycemic properties [1]. The beneficial effects of tea are mainly due to catechin, L-theanine, and caffeine. Studies proves that catechin improves cognition, working memory and memory recognition...... ReadMore

Dalhatu A*

DOI : 10.32474/GJAPM.2019.02.000135

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High-blood pressure episode is a strong independent risk factor for death from heart disease and stroke. It is usually common diagnostic investigations in modern day cardiology especially in high temperate region where its cut across all ages. Hot temperate regions, Nigeria inclusive has recorded appreciable headway in improving the health care outcomes of its populations, in spite of the challenges posed by pervasive poverty, epidemic diseases, and food insecurity. Checking out both communicable and noncommunicable disease is necessary if quality and effective health care service is to be made available in the context of primary healthcare development. This article reviewed relevant literatures related to hypertension, prevalence and its associated risk which were published by journals nationally and internationally. There is increasing..... ReadMore

Christos Christoforidis*

DOI : 10.32474/GJAPM.2019.02.000134

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Objective: To present the diagnostic and clinical features including management of acute compartment syndrome of the foot and to create a sense of emergency amongst orthopaedic surgeons of this rare and dangerous condition. Clinical features: A 19-year old young man presented at the emergency department referring a twisting injury of his left ankle presented with swelling and pain after an acute second-degree lateral ankle sprain. The patient was treated with the RICE protocol (rest, ice, compress and elevate). Two days later, the patient returned at the emergency department, late at night with severe swelling, paresthesia, reffering an excruciating pain at his left foot and inability to walk. A diagnosis of foot compartment syndrome was made. Intervention and outcome: An emergency fasciotomy of the lateral and medial compartment (dual ..... ReadMore

Nouraddin Abdi Goushbolagh*

DOI : 10.32474/GJAPM.2019.02.000133

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The fact remains that, despite significant progress has been made in the treatment of cancer, many patients with advanced cancer still suffer from pain. Cancer-induced bone pain (CIBP) is the most common type of cancer pain, which breast, prostate, and lung cancer are associated with high skeletal metastases that caused to patient’s bone pain. As matter of fact, two-thirds of patients with bone metastases suffer from fractures pain, not all bone lesions are painful. In this connection, mechanisms that caused to pain in cancer patients include periosteal irritation nerve entrapment, muscle spasm, and secretion of chemical mediators of osteolysis such as prostaglandines and cytokines which activate concomitantly both osteoclasts and nociceptors [1]. It would be better to say that, pain management is vital aspect of cancer treatment which..... ReadMore

Ayse Veyhurda Dikmen*

DOI : 10.32474/GJAPM.2019.02.000132

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Background: In this era of innovation and technology, the major expectations about male healthcare are getting rid of erectile dysfunction without any adverse effects as well as providing the best rates of fertility dedicatedly ever after. Objective: To investigate the effectiveness of magnesium sulphate in treatment of postoperative agitation following functional endoscopic sinus surgery. Design, setting and participants: In this study, a total of 2200 men with borderline erectile dysfunction and infertility and aged between 35-58, had 6 months of duration of treatment with 5mg daily tadalafil. The pretreatment and posttreatment semen parameters of the patients were evaluated retrospectively. Outcome measurements and statistical analysis: The evaluated semen parameters were pH, concentration, volume and motility rates before and after..... ReadMore