Billroth Hospitals

Introduction:Chondroblastomas (CB) are rare benign cartilaginous tumors (1%) arising from secondary ossification centers in epiphysis of long bones, commonly the proximal humerus. They commonly occur in the 2nd decade of life and have a male predilection. The occurrence of these tumors in the patella is extremely rare (<2%).Case Report:A 16-year-old male presented with knee pain since 2 months, which aggravated with activities. Radiographic evaluation showed an osteolytic lesion along the superolateral pole of patella, which was hypointense on T1 and hyperintense on T2 along with multiple fluid-fluid levels, suggestive of aneurysmal bone cyst (ABC). Intralesional curettage was performed along with bone grafting from the ipsilateral iliac crest. Histopathological examination showed presence of chondroblasts along with abundant osteoclast-like giant cells, suggestive of a CB with a secondary ABC. The patient was able to return to his day-to-day activities after 4 weeks.Conclusion:CB with secondary ABC represents a diagnostic challenge due to atypical imaging features that mimic primary ABC. One must maintain high suspicion for this entity when evaluating lytic patellar lesions. Adequate tissue sampling and histopathological examination are mandatory for accurate diagnosis, as radiological findings alone are insufficient. Appropriate surgical management with intralesional curettage and bone grafting results in excellent functional recovery and low recurrence rates.

Emergency below-knee amputation (BKA) in patients with significant comorbidities and coagulopathy presents formidable anesthetic challenges, as a central neuraxial blockade and general anesthesia are frequently contraindicated. We report the case of a 57-year-old female patient with uncontrolled diabetes mellitus, chronic kidney disease, coronary artery disease, and an elevated international normalized ratio (INR) of 1.6, necessitating urgent BKA for a septic diabetic foot ulcer. Ultrasound-guided peripheral nerve blocks (PNBs, popliteal sciatic and femoral) have been successfully employed to achieve effective intraoperative anesthesia and postoperative analgesia without bleeding complications or hemodynamic instability. This case underscores the safety and efficacy of ultrasound-guided PNBs as the preferred anesthetic strategy in high-risk patients with coagulopathy, offering a safer alternative to conventional methods and minimizing perioperative morbidity.

Introduction: Breast milk is the best and most comprehensive source of nutrients for babies. Poor baby feeding practices are the cause of 60% of infant and early child mortality worldwide. The growth and development of children may be negatively impacted by inappropriate newborn feeding practices, particularly in underdeveloped and developing nations. Hence the present study was undertaken to determine the Breast-feeding Practices among Primipara Mothers at Selected Community, Chennai. Methods: A descriptive correlational design was used. The study was carried out in a community area in Chennai. Using the purposive sampling technique, 100 primipara mothers with infants between the ages of 1-12 months who fulfil the inclusion criteria were selected after obtaining formal agreement from the relevant authorities of the selected community area and ethical clearance from the institutional ethical committee. The data was gathered through interview method using pre-tested instruments such as background variable proforma, obstetrical variable proforma, and proforma to evaluate primipara mothers' breastfeeding practices. Results: The study findings revealed that 73% of the primipara mothers had moderately adequate practice. None of them in the category of needs improvement. There was a significant association between selected obstetrical variables such as mode of delivery and practice on breast feeding in primipara mothers (p&lt;0.05). Those who had normal vaginal delivery had good practice when compared to those who delivered through LSCS.

Spirometry is the most common type of pulmonary function or breathing test. It is one of the most readily available and useful tests for pulmonary function. It measures the volume of air exhaled at specific time points during complete exhalation by force, which is preceded by a maximal inhalation. The most important variables reported include total exhaled volume, known as the forced vital capacity (FVC), the volume exhaled in the first second, known as the forced expiratory volume in one second (FEV1), and their ratio (FEV1/FVC).The test can play an important role in diagnosing and managing many lung problems. It can help distinguish between diseases with similar symptoms and determine whether the condition is obstructive and/or restrictive.

This review article summarises need for and means of anticoagulation therapy in COVID-19. One of the major cardiovascular hazards noted in about more than 20% of critically ill COVID-19 persons, which is 3-4 fold higher than the critically ill viral pneumonia patients. When surveillance venous ultrasonography was performed, the frequency of VTE was as high as 69%. Autopsy studies had shown nearly 88% had widespread thromboembolic disease. Small arteries (<1mm) had fibrin thrombi in 87%. As the understanding of COVID coagulopathy unfolds, the approach to anticoagulation continues to evolve. Precise mechanism behind the increased thrombogenicity of COVID-19 is still in completely understood, and further research is needed. In a large registry of COVID-19 patients given thromboprophylaxis, the overall rate of thrombotic events was comparable with other similar patients receiving thromboprophylaxis in pre-COVID times. This gives hope that with appropriate anticoagulation, the coagulopathy associated with COVID-19 can be managed well. As such anticoagulation in this vulnerable population should be considered with utmost care, with special emphasis in balancing associated co-morbidities, thrombotic risk, bleeding risk and potential drug interactions.

Introduction: There is a growing concern regarding self-care and chemotherapy side effects. The present study aimed to assess the effectiveness of self-care measures on knowledge, self-efficacy, and performance status among cancer patients undergoing chemotherapy.Methods: A quasi-experimental study was conducted in Dr. Kamatchi Memorial Hospital, India. Using purposive sampling technique, 200 cancer patients were selected. Patients were interviewed using semi-structured knowledge questionnaires, Modified Stanford Patient Education Research Center Self-efficacy scale, deliberate self-efficacy with rating scale under four subheadings, and ECOG Performance Status Scale with 5–point grading scale i.e., dead to fully active.Results: There was adequate knowledge (95%) on self-care measures after the intervention. The mean score was significant, i.e., 21.33 (2.25), which had difference between post-knowledge score in experimental and control was statistically significant at P < 0.001 level. The majority of patients reported a high self-efficacy level (t = 198.60, P < 0.001). In addition, despite self-efficacy and knowledge the performance status observed at each cycle, i.e., 4 cycles had mean score of t = 32.13, P < 0.001, showed high level of performance status.Conclusion: The study revealed that the self-care measures during each cycle had improved the selfefficacy and performance status to high level, which in turn reduced the side effects of chemotherapy to the certain level.

Abstract We present an interesting case of a large intra-abdominal cystic lesion in a 14-year-old girl who presented with abdominal discomfort and pain. The patient was evaluated with magnetic resonance imaging (MRI) and found to have a large septated cystic lesion arising from the gastrohepatic omentum. She underwent surgery, and the diagnosis of cystic mesothelioma was confirmed in the histopathology. To the best of our knowledge, only a few cases of benign omental mesothelial cysts have been reported.

Abstract We present a rare case of spontaneous intrasplenic varix in a patient with chronic liver disease and portal hypertension. The venous collaterals and presence of portal hypertension was incidentally detected by abdominal contrast-enhanced computed tomographic imaging during evaluation of a suspected abdominal trauma following a road traffic accident. There have been a few reports of splenic vein aneurysms in the extrasplenic location. To the best of our knowledge, this is the first reported case of intrasplenic varix that developed in an adult with chronic liver disease and portal hypertension which is a rare manifestation of a well-known disease.