Comparative Evaluation of Thoracoscopy Versus Thoracotomy in the Management of Lung Hydatid Disease

Background  

Lung hydatid disease is an endemic problem in Mediterranean countries, and the ideal surgical management for it is still debated. In this prospective study, we aimed to evaluate the feasibility and safety of thoracoscopy in patients with lung hydatid disease. We studied the advantages of thoracoscopic procedure over posterolateral thoracotomy.     

GEOGRAPHICAL PATTERN OF PEMPHIGUS IN NORTH INDIA

A clinical analysis of 70 patients suffering from various types of pemphigus is presented. It revealed a characteristic morphology, and occurrence in a relatively younger age group. Sex had hardly any impact on the disease. Pemphigus vulgaris constituted the largest group. Corticosteroids were the mainstay of its treatment although both lower initial and maintenance dosages were needed in our patients in contrast to those of the standard literature.     

Nonunion of the diaphysis of long bones

The treatment of diaphyseal nonunion of long bones is difficult and controversial. We retrospectively reviewed 113 patients with diaphyseal nonunion treated by various modalities, during 15 years at one institution. There were 36 cases of nonunion of the tibia, 23 nonunions of the femur, 21 nonunions of the humerus, 13 nonunions of the radius, 18 nonunions of the ulna and two nonunions of the clavicle. The minimum followup was 24 months (average, 40 months, range 2-15 years). The nonunions were classified as aseptic (84) and septic (29) and additionally classified as hypertrophic (61) and atrophic (52) in order to determine the treatment. The treatment was individualized based on the stability at the nonunion site, need for bone grafting, and control of infection. All fractures healed and every patient in the study regained functional use of the limb without pain or instability and functional range of movements that they had at the time of presentation with nonunion. Residual problems seen in some patients were joint stiffness, limb length discrepancy, and angular deformity. Twenty-six patients required repeat surgery using bone grafting because no satisfactory progress of fracture healing was seen in 4 months. Complications were related to the iliac crest donor site and persistent infection at the nonunion site.     

HIV and cerebral aneurysms

Patients infected with the human immunodeficiency virus (HIV) or suffering from acquired immunodeficiency syndrome (AIDS) are now surviving for longer periods of time secondary to improvements in medical management. As the classical causes of morbidity and mortality in this patient population have come under better control, new complications are becoming more prevalent. In our clinical practice, there appears to have been a rise in the number of patients with HIV infection and AIDS who have experienced aneurysmal subarachnoid hemorrhage (SAH). In this paper, we review the available literature regarding cerebral aneurysms in patients infected with HIV and/or suffering from AIDS.