Introduction: Various treatment modalities are available butno consensus has been reached for optimal treatment oflateral third clavicle fractures. Precontoured locking plateswith broad lateral end for multiple screws fixation is a newlydesigned plate for lateral third clavicle fractures. Theobjective of our study was to analyse the functionaloutcomes as well as complications of this technique in asignificant number of cases with long follow-up duration.Materials and Methods: Forty-six patients with distal thirdclavicle fractures were treated by precontoured clavicularlocking plate with broad lateral end. Functional outcomeswere assessed on the basis of Constant-Murley ShoulderOutcome Score and University of California, Los Angeles(UCLA) Shoulder Rating Score, active shoulder range ofmotion, time for fracture union and coraco-claviculardistance.Results: The mean Constant-Murley score was 92.56±4.47(range: 79-98) for injured side and 96.22±2.23 (range: 90-100) for normal side with p-Value 0.56. Mean coracoclaviculardistance at final follow-up was 10.52±1.13 mm(range 9.7 to 11.7 mm) in injured side and 10.25±0.98 mm(range 9.6 to 11.2 mm) in normal side. Mean UCLAShoulder Rating Score was 32.55±2.12 (range: 27-34) forinjured side and 33.46±1.88 (range: 31- 35) on normal sidewith p value 0.58. No major complications that necessitatedrevision of surgery occurred in our study.Conclusion: This newly designed plate seemed extremelyuseful in successful union of lateral third clavicle fractures,with reduced rate of complications like fixation failures,iatrogenic rotator cuff injury, AC joint osteoarthritis andsub-acromial bursitis, with good functional out

Although the surgical management of spontaneous intracerebral hematoma (SICH) is a controversial issue, it can be life saving in a deteriorating patient. Surgical techniques have varied from the open large craniotomy, burr hole and aspiration to the minimally invasive techniques like stereotactic aspiration of the SICH, endoscopic evacuation and stereotactic catheter drainage. The authors report their experience with a keyhole craniectomy for the surgical evacuation of SICH. Ninety-six cases of SICH were treated using the keyhole craniectomy technique. A small craniectomy of 2-2.5 cm diameter was made using a vertical incision over a relatively ‘silent area’ of the cortex closest to the clot. Using a small cortical incision the hematoma was evacuated and decompression was achieved. Hemostasis was achieved using standard microneurosurgical techniques. Good to excellent outcome was achieved in 55 cases. Mortality was noted in 23 patients. Blood loss was minimal during the procedure. Good evacuation of the clot was seen in all but 5 cases as judged by the postoperative CT scan. The keyhole craniectomy technique is minimally invasive, safe and can achieve good clot evacuation with excellent hemostasis. It can be combined with microscopic or endoscopic assistance to achieve the desired result.
Hematoma ; Methodology ; Good ; desires <1> ; Hemostasis procedure

Subcutaneous dirofilariasis is a parasitic infestation found in endemic areas in Mediterranean countries such as Italy. It is occasionally reported in India, mostly from the state of Kerala. Presentation in an infant is extremely rare. We report a case of subcutaneous dirofilariasis in a child that was diagnosed by ultrasonography and confirmed by surgery.
Connective Tissue Diseases ; diagnosis ; diagnostic imaging ; parasitology ; surgery ; Dirofilariasis ; diagnosis ; diagnostic imaging ; surgery ; Female ; Humans ; Infant ; Subcutaneous Tissue ; Ultrasonography

Cryptococcosis is a life-threatening mycosis typically seen in immunocompromised patients. Pulmonary cryptococcosis generally presents as multiple or solitary nodular opacities. Cryptococcal infection presenting as a destructing cavernoma (cryptococcoma) without diffuse infiltration of the lung is an extremely rare presentation, even in immunocompromised patients. This report presents a healthy, HIV negative, immunocompetent patient who presented with a large solitary lung mass provisionally diagnosed as a lung malignancy on radiological imaging that proved to be a large cryptococcoma after biopsy. The patient was treated with liposomal Amphotericin B and fluconazole, and the lesion showed regression on serial imaging. This case report thus highlights an unconventional presentation of pulmonary cryptococcosis in an immunocompetent individual.

Novel coronavirus disease, the latest world pandemic is one of the most contagious viral infections to date. There has been a lack of uniformity on recognizing this condition clinically because of poorly understood pathophysiology and clinical nature. Also due to ongoing clinical trials, its management is also varied. This is a systematic review from evidence-based studies until March 1st, 2020, covering an update on its clinical features and management. This study shows the multisystem involvement of COVID-19 with dominant respiratory features followed by the musculoskeletal, gastrointestinal system and others. The clinical features varied from asymptomatic to severe forms. Major causes of fatality were acute respiratory distress syndrome, shock, acute cardiac injury, acute kidney injury, rhabdomyolysis, and arrhythmia. Major modalities of management included supportive, antiviral and antibiotic therapy. There was no direct relationship between the specific treatment and the outcome.