The perforator-plus flap appears to be a versatile and reliable option in lower limb injuries and other diverse indications, in both the emergency and the elective settings.

The NT-pro-BNP levels are significantly elevated in RCM as compared to CP.

No abstract

Since the initial description of tropical pyomyositis 130 years ago, this disease continues to retain some mystery for physicians and surgeons. The infrequency, variable epidemiologic and demographic profile, diagnostic dilemmas and limited literature continue to make it an enigma with limited understanding. In the span of nearly 130 years, worldwide English literature search has revealed an average of only two to three reported cases every year globally. We recently managed a case of tropical pyomyositis which posed a clinical and radiologic diagnostic dilemma. The rarity of disease and published literature prompted us to garner demographic and disease characteristics data from historical review of two Pan-Indian journals, with the aim of aiding management. Data has been screened since 1950 from the Medical Journal Armed Forces India (MJAFI) and the Indian Journal of Surgery (IJS), which report cases from different geographical conditions and ethnicity all over the nation. We found only six case reports in the MJAFI, while there was surprisingly no publication regarding pyomyositis in the IJS. We present a case report of a 39-year-old male who developed pyomyositis of the left calf muscle and review published data from these journals over the last 65 years.

Post operative sore throat and hoarseness are common complications after endotracheal intubation. We conducted an experimental, randomized, double-blind study to compare the effectiveness of preoperative nebulisation with ketamine, budesonide and lignocaine in reducing the incidence and severity of post operative sore throat. MATERIAL & METHODS 120 patients (aged 20-60 years) scheduled for elective surgery under general anaesthesia were enrolled. Preoperatively , patients were nebulized with ketamine (Group 1) , Budesonide (Group 2) , Lignocaine (Group 3) and distilled water (Group 4). Number of attempts required for intubation, duration of laryngoscopy and anaesthesia were recorded. Patients were evaluated post operatively at various time intervals for sore throat, hoarseness and cough, pain and signs of mucositis in laryngopharynx. RESULTS The incidence of sore throat at different time intervals was found to be least in ketamine group at 1 hr, by lignocaine at 24 hrs and budesonide at 48 hrs.. Lignocaine reduced cough at 1 and 24 hrs. Incidence of hoarseness was comparable in all the groups. CONCLUSION Nebulisation with lignocaine was efficacious in reducing cough , and ketamine reduced sore throat in early post operative period , whereas long term outcome was better with budesonide.