Injuries deeper than the platysma are considered as penetrating neck injuries, constituting approximately 5% - 10% of all trauma. Many vital organs are at risk from a penetrating neck injury. These injuries in zone 1 have the highest mortality, because the injuries are close to the vital organs and difficult to access surgically. A 41-year-old male, a car mechanic by profession, presented to the emergency department with a penetrating neck injury on the right side. CT scan demonstrated a metallic foreign body in zone 1 between the right internal jugular vein and the common carotid artery. The patient was asymptomatic, and the foreign body was removed surgically. This case shows a rare presentation of a penetrating neck injury with a foreign body located in zone 1, where no vital internal structure was injured. As of now, no previous case report has been identified on such presentation. Thus, it will provide a valuable addition to the pre-existing literature.
Humans ; Male ; Adult ; Neck Injuries/diagnostic imaging* ; Wounds, Penetrating/diagnostic imaging* ; Foreign Bodies/diagnostic imaging* ; Jugular Veins ; Tomography, X-Ray Computed ; Carotid Artery Injuries/surgery* ; Carotid Artery, Common

Objectives: Postmenopausal females often experience genitourinary symptoms like vulvovaginal dryness due to estrogen decline.Hormone replacement therapy is effective in alleviating vaginal atrophy and genitourinary syndrome in this population. Evaluate local estrogen’s safety and effectiveness for alleviating postmenopausal vaginal symptoms, including endometrial thickness, dyspareunia, vaginal pH, and dryness. Methods: We searched Google Scholar, Cochrane Library, ClinicalTrial.Gov, PubMed, and ScienceDirect databases until July 2023. All randomized controlled trials (RCTs) linking intravaginal estrogen supplementation to vaginal atrophy or vaginitis were included. The risk of bias was evaluated with RoB 2, and publication bias was assessed using Egger and Beggs analysis. Results: All evidence pertains to females. Eighteen studies (n = 4,723) compared estrogen with placebo. Patients using estrogen showed a significant increase in superficial cells (mean differences [MD]: 19.28; 95% confidence intervals [CI]: 13.40 to 25.16; I2 = 90%; P < 0.00001) and a decrease in parabasal cells (MD: –24.85; 95% CI: –32.96 to –16.73; I2 = 92%; P < 0.00001). Vaginal pH and dyspareunia significantly reduced in estrogen users (MD: –0.94; 95% CI: –1.05 to –0.84; I2 = 96%) and (MD: –0.52; 95% CI: –0.63 to –0.41; I2 = 99%), respectively. Estrogen did not significantly affect vaginal dryness (MD: –0.04; 95% CI: –0.18 to 0.11; I2 = 88%). Adverse events like vulvovaginal pruritis, mycotic infection, and urinary tract infection were reported, but the association was insignificant (risk ratio: 0.95; 95% CI: 0.88 to 1.02; I2 = 0%). Conclusions Our meta-analysis of 18 RCTs suggests promising potential for intravaginal estrogen therapy in alleviating vaginal atrophy and vaginitis in postmenopausal females.

The jejunum is the longest part of the small intestine and its lumen is mainly involved in the absorption of the nutrients. The present study was conducted to evaluate the effects of metronidazole, ceftriaxoine sodium and their combination on the stenotic index of the end to end jujunal anastomotic site. To accomplish this, 20 healthy stray dogs were subjected to end to end jejunal ansastmosis. Dogs in Group A (control) underwent jejunal anstomosis with no antibiotic prophylaxis, while those in Group B received surgery and metronidazole alone at 50 mg/kg, those in Group C received ceftriaxone sodium intravenously at 30 mg/kg body weight prior to surgery and dogs in Group D were given metronidazole in combination with ceftriaxone sodium at 50 mg/kg and 30 mg/kg, respectively, 2 h before surgical intervention. No significant difference (p > 0.05) in the stenotic index was observed at 14 days after jejunal anastomosis. These findings indicate that prophylactic administration of metronidazole and ceftriaxone sodium alone or in combination had no significant effect on the stenotic index of the jejunum.
Absorption ; Animals ; Antibiotic Prophylaxis ; Body Weight ; Ceftriaxone* ; Dogs* ; Intestine, Small ; Jejunum ; Metronidazole* ; Sodium