Background Obesity is a risk factor for increased peri-operative morbidity and mortality in surgical patients. There have been limited studies to correlate the morbidity of lung cancer resection with obesity. Methods We performed a retrospective study of patients who underwent surgical resection for lung cancer at the Medical College of Wisconsin from 2006 to 2010. Data on patient demographics, weight, pathology findings and hospital course were abstracted after appropriate IRB approval. Peri-operative morbidity was defined as atrial fibrillation, heart failure, respiratory failure, pulmonary embolism or any medical complications arising within 30 days after surgery. Fisher’s exact test was used to test the association between BMI and peri-operative morbidities. Results Between 2006 and 2010,320 lung resections were performed for lung cancer. Median age was 67(IQR 59–75) years and 185(57.8%) were females.121 (37.8%) patients had a BMI<25 and 199(62.18%) patients had a BMI≥25. The 30-day mortality rate was 1.8 % (n=6) in the whole group; only 2 of these patients had a BMI ≥ 25. Peri-operative morbidity occurred in 28(23.14%) of normal BMI patients and in 47(23.61%) of BMI ≥ 25 patients (p=0.54). Specific morbidities encountered by patients with normal vs. BMI ≥ 25 were: atrial fibrillation 11(9.09%) vs. 24(12.06%) (p=0.46), Pulmonary embolism 1(0.83%) vs. 3(1.51%) (p=1.0), congestive heart failure 2(1.65%) vs. 2(1.01%) (p=0.63), renal failure 4(3.3%) vs.2 (1.0%)(p=0.29), respiratory failure 12(9.92%) vs. 17(8.54%) (p=0.69) and acute respiratory distress syndrome 2(1.65%) vs. 1(0.50%) (p=0.55). Median hospital stay was 5 days in the lower BMI group and 4 days in the BMI ≥25 groups (p=0.52). Conclusions Overweight and normal weight patients do not differ significantly in rates of perioperative morbidities, 30-day mortality and length of stay. Our study indicates that potential curative surgical resections can be offered to even significantly overweight patients.

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Acute chest syndrome (ACS) in sickle cell disease is caused by thromboemboli in the pulmonary vasculature. The diagnostic criteria include the presence of pulmonary infiltrate(s) on chest x-ray. This case report suggests that a V/Q scan may play a diagnostic role in sickle cell patients with symptoms of ACS and a negative chest x-ray. Am.

To evaluate the functional and radiological outcome in medial compartment osteoarthritic knee treated with proximal fibular osteotomy as a new modality of treatment. Materials and Methods: Fifteen patients (10 men and 5 women, age range between 50-68 years) from May 2016 to May 2018 who had undergone proximal fibular osteotomy for medial compartment osteoarthritis knee were followed prospectively. Pre-operative and post-operative weight bearing scan gram obtained to analyse the alignment of lower limb (Femoro tibial angle) and ratio of joint space (medial/lateral joint space). Functional Outcome was assessed with American Knee Society Score (KSS) and Knee pain was assessed with Visual analogue scale. Results: At final followup the mean Femoro-Tibial angle and joint space ratio were 180.4 and 0.54 respectively. The limb alignment is corrected in few cases and joint space ratio is increased postoperatively. Mean Knee Society Score at final follow up was 75.13 which was higher than the mean preoperative score 52.5.Mean Vas score is reduced significantly up to 4(preoperative mean Vas score was 8). Conclusion:The present study demonstrates the proximal fibular osteotomy effectively relieves the pain and improves the joint function in the patients with medial compartment osteoarthritis of knee by shifting the mechanical axis. Conversion to total knee replacement or unicompartmental arthroplasty is also less complicated.