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  • ISSN: 2333-6641
    Volume 1, Issue 2
    September/October 2013
    Case Report
    Thisara C. Weerasuriya*, Francis Chan, and Narendra Pinto
    Abstract: Fracture neck of femur is a common orthopaedic condition which is increasing in incidence in the whole world with the aging of the populations. In this study done in Sri Lanka and the UK over a period of three years a total of 256 fracture neck of femur patients were observed for post-operative duration of stay, pain scoring and date of first mobilization. This study was done prospectively from January 2010 to January 2013. A retrospective analysis of 256 patients who had operations for fracture neck of femur from 2007 to 2010 who did not receive local anaesthetic infiltration into the surgical wound were done to compare the results between the two groups.
    The mean stay in hospital for the group of patients who had local anaesthetics injected was 05 days where as for the group of patients who did not have such injections was 06 days. At a p value of 0.05 there was no statistical significance noted between the two groups. The post-operative pain score of 0-10 on the first postoperative day, the group who had local infiltration had a mean score of 04 where as the group that did not have infiltration had a mean score of 06. Once again this was not statistically significant at a p value of 0.05. At the 04th post-operative day both groups had a mean pain score of 04.
    The group that received local infiltration of the wound were able to mobilize from bed to chair on a mean of 1.5 days post-operatively while the group that did not receive local infiltration mobilized from bed to chair on a mean of 2 days which was not statistically significant.
    There was no statistically significant difference between injecting local anaesthesia to the operative incision site in patients who have had surgical operations for fracture neck of femur. The pain due to the incision itself played a minor role in the total pain profile and there was o statistical significance of eliminating the wound pain in these patients.
    José M. Belena1*, Monica Nunez1 and Alfonso Vidal1,2
    Abstract: Hereditary angioedema (HAE) is a rare genetic disorder resulting from an inherited deficiency or dysfunction of the C1-esterase inhibitor. It is characterized by recurrent and self-limiting angioedema episodes, most often affecting the skin or the mucosal tissues of the upper respiratory and gastrointestinal tracts.
    Androgens and fresh frozen plasma (FFP) are frequently used as treatment despite multiple, significant side effects. Newer therapies include C1-inhibitor concentrate (C1-INH) and contact system modulators such as ecallantide and icatibant. In addition, C1-INH can also be used for prophylaxis.
    We present the case of a 47-year-old male with a previous diagnosis of HAE, underwent elective lumbar interbody arthrodesis under general anesthesia. Following prophylaxis with danazol and C1-INH, surgery was carried out uneventfully with an unremarkable postoperative course. Perioperative prophylaxis to avoid acute attacks and anesthetic management are discussed.
    Madhumani N. Rupasinghe*, Steven C. Osborne, Aseem R. Hemmad, and Doyle
    Abstract: The transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia for patients undergoing midline abdominal wall incisions. We evaluated retrospectively, the analgesic efficacy of an ultrasound guided TAP block for post CS analgesia to determine if it would reduce patient-controlled analgesia (PCA) morphine consumption in the first 24 h after surgery.
    Research Article
    Nicholas V Mendez1#, Jeffrey A Wharton1#, Jenna L Leclerc1, Spiros L Blackburn2, Martha V Douglas-Escobar3, Michael D Weiss3, Christoph N Seubert1 and Sylvain Doré1,4*
    Under physiologic conditions, the normal turnover of red blood cells releases hemoglobin, which is further broken down into heme and amino acids (from the globin part). Heme oxygenase (HO) is the rate limiting enzyme in the conversion of heme into unconjugated bilirubin, and it exists in the brain as two isoforms: HO-1 and HO-2 [1]. The production of HO-1 is inducible by heme and oxidative stress, both of which are present following pathologic events such as hemorrhagic stroke [2].
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