Alkaptonuria, a metabolic disorder with urological manifestation goes unnoticed till we are aware of it. Here we present an alkaptonuric patient with difficult catheterisation was diagnosed with a large prostatic calculus and his management.

In this paper we analyze, through a mathematical model, the potential impact of HCV antiviral therapy on the liver transplantation waiting list (LTWL) in the State of Sao Paulo, Brazil.

Objective: To determine the effectiveness of topical vancomycin in reducing the incidence of sternal wound infections (SWI) in patients undergoing coronary artery bypass graft (CABG) surgery. Study design: Randomized Controlled Trial (RCT). Material and methods: This double blinded randomized clinical trial was carried out on 276 patients scheduled for elective CABG surgery. Patients were divided into two equal groups. In patients of group A (n=138) topical vancomycin solution was used in the sternal wound, and patients in group B (n=138) topical normal saline before sternal wound closure in coronary artery bypass graft surgery. The incidence of sternal wound infection was followed over an 18 months period. Major risk factors like diabetes mellitus (DM), smoking, and prolonged operation time i,e cardiopulmonary bypass time (CPB time) and cross clamp time were also evaluated.

Introduction: trauma is common in pregnancy; it affects one in twelve pregnancies. Abdomen represents the third anatomical region of the body most affected after the limbs and head. As pregnancy evolves, uterus increases in size and goes beyond the pelvic cavity; exposing the uterus to trauma and penetrating injuries in particular. Penetrating abdominal trauma in pregnancy requires a rigorous clinical evaluation to establish a complete assessment of obstetric and non-obstetric lesions. It is an obstetrical emergency whose management depends on the abnormalities found. In case of major trauma, it is essentially carried out in a trauma center, with a multidisciplinary team to improve the maternal and fetal prognosis.

Lumbar hernias are a rare clinical presentation and are usually congenital, traumatic or spontaneous. We describe an unusual case of a pathological lumbar hernia due to recurrent retroperitoneal abscesses, likely precipitated by chronic tip appendicitis. A literature search of PubMed with the search terms “lumbar OR flank AND hernia” and “abscess” found only one similar published case.

Objectives: The formation of bacterial biofilm on implant surfaces is the primary etiologic reason for peri-implantitis. The aim of this study is to present a new formulation including erythritol powder, which is widely used in air-polishing devices, and ultrasonic scaler with polyetheretherketone-coated tips, and to compare treatment effectiveness of them by comparison with conventional plastic scaler with 0.12% chlorhegxidine decontamination.

Background: The aim of our study was to demonstrate if there is any relation between the neutrophil-to-lymphocyte ratio (NLR) and mortality in severe burns. Methods: The records of 366 patients who were admitted to Intensive Care Unit of Burn Center of Derince Training and Research Hospital between January 2012 and December 2015 were evaluated retrospectively. The cases who were hospitalized in service or did not require intensive care were not included in the study. The cases were divided into two groups: ex-group (Group 1) and discharge group (Group 2). In both groups demographic information such as age, gender, burn scores, neutrophil counts and lymphocyte counts during admission to the hospital were recorded. NLR is the ratio of absolute neutrophil count to the absolute lymphocyte count.

Gallbladder volvulus (GV) is a rare surgical emergency in which the gallbladder twists on its pedicle and becomes gangrenous. It most commonly presents with symptoms similar to acute cholecystitis. Investigations are seldom diagnostic, with both pathology tests and imaging often unremarkable, and as such it is often diagnosed intraoperatively. Given the potential consequence of a ruptured gallbladder leading to biliary peritonitis, it is an important condition to consider and suspected cases should proceed to cholecystectomy as soon as possible. We report the case of an elderly female patient who initially presented as having an acute coronary syndrome then was found intraoperatively to have GV, and discuss clinical points of the disease.

Rectal foreign bodies (RFBs) are an unusual emergency presentation readily confirmed via clinical examination and imaging, which must be quickly removed due to the risk of rectal wall tissue damage leading to perforation and subsequent peritonitis. Several non-operative methods are described in the literature to retrieve RFBs, however removal can be especially difficult if they not easily graspable, for example a ball-like object. We present the case of a spherical RFB successfully extracted using a vacuum-assisted delivery device.

Purpose: To identify body types and normative transformation after obesity surgery and body re-contouring. Methods: A qualitative secondary analysis was conducted involving 20 transcripts, extracted from one primary dataset containing interview data. A model of empirically grounded type construction was employed and adapted to analyse data. Results: Four emerging body types were revealed including type 1 ‘identity disruption’, type 2 ‘overcoming identity lag’, type 3 ‘refining appearance’ and type 4 ‘transformed new me’. The findings shed light on the normative transformation process and the huge challenges that patients encounter. It is crucial to acknowledge that body types 1 and 2 experienced identity disruption and emotional turmoil, post body recontouring surgery. Contrastingly, types 3 and 4 showed strong determination and resilience throughout the transformation process despite embodied turbulence

Primary tumours arising from sternum are rare. We came across two patients with primary tumours arising from sternum, one malignant (Ewings sarcoma) and the other benign in nature (giant cell tumour) which are very uncommon. After wide local excision the reconstruction was done by using autologous free rib graft in one and titanium mesh in other. In both the cases the coverage was provided with pectoralis major muscles. After six months both were disease free with chest wall integrity well maintained. We believe the reconstructive options adopted by our team for these cases are simple, bio-compatible and reproducible.

Introduction: Gallbladder polyps (GP), especially adenomatous, is quite rare. The prevalence of GP globally is variable, its importance comes from its potential to progress to gallbladder adenocarcinoma.