Thorupdonnelly9192

Spanning internal fixation provides a safe and effective technique in the management of complex upper cervical spine injuries without the drawbacks of using a halo-vest orthosis.The craniocervical junction (CCJ) is a complex and unique osteoligamentous structure that balances maximum stability and protection of vital neurovascular anatomy with ample mobility and range of motion. With the increasing utilization and improved resolution of cervical magnetic resonance imaging, craniocervical injury is being more accurately defined as a spectrum of injury that ranges in severity from overt craniocervical disassociation to isolated injuries of one more of the craniocervical ligaments, which may also lead to craniocervical instability. Thus, it is vital for the radiologist and neurosurgeon to have a thorough understanding of the imaging anatomy and function of the CCJ.Emphysematous pyelonephritis (EPN) is a life-threatening infection of kidney with the presence of gas in the renal parenchyma, collecting system, and the surrounding retroperitoneum. We present a case of EPN in a diabetic patient with extension of gas into the spinal epidural space of the lumbar vertebral canal. He was managed conservatively with minimally invasive intervention along with supportive medical management and recovered well.Metastatic involvement of the urethra is a rare finding in patients with carcinoma prostate. The signs and symptoms overlap with those of a primary urethral malignancy. The diagnosis is made following a biopsy of the suspected lesions. We describe the case of a 66-year-old patient with carcinoma prostate who presented with penile pain, 18 months after the treatment with androgen deprivation therapy. Ga-68 prostate-specific membrane antigen positron emission tomography/computed tomography helped in the identification of the urethral and inguinal nodal metastasis, which was confirmed histologically. We also discuss the management of this unusual clinical scenario.Centrally located completely endophytic renal hilar tumors pose a technical challenge, especially during a minimally invasive surgery. Relation of the tumor to the renal vasculature decides the approach. Tumors placed anterior to the vasculature can be approached in the anterior trans-hilar manner. However, tumors placed posterior to the vasculature need a posterior approach, which is quite a difficult maneuver during transperitoneal laparoscopy. Adequate exposure to access the resection plane is the key principle. We describe a laparoscopic technique for enucleation of such tumors, applying the surgical principle of radial nephrotomy in the intersegmental plane which is usually performed to remove renal stones.Drug-induced priapism is well known and papaverine is the most common drug known to cause priapism. Drotaverine, an analog of papaverine, is used extensively to treat Colicky pain. We report the first case of drotaverine.induced priapism.Hemophilia is a rare disorder that is difficult to diagnose and manage. The prevalence of end-stage renal disease is increasing in hemophilic patients because of improved life expectancy. Renal transplant surgery in such patients is often complicated by adverse hematological events such as bleeding and intravesical thrombosis, both with a risk of renal allograft rejection. We report a case of a 46-year-old hemophilia A patient on hemodialysis who underwent renal transplant and show that although challenging, renal transplant in hemophilic patients is possible.Primitive neuroectodermal tumor (PNET)/Ewing's sarcoma tumors are a group of highly malignant tumors composed of small, round cells showing neuroectodermal differentiation that commonly affects soft tissue and bone. L-glutamate mw PNET involving the genitourinary system is rare and PNET of the penile urethra is rarer still. It exhibits a highly aggressive biological behavior with poor prognosis. We report a case of a 27-year-old male presenting with penile swelling and difficulty in passing urine. Examination revealed a firm penile urethral mass. Pathological and immunohistochemical results of the specimen obtained from urethroscopic biopsy followed by total penectomy confirmed the diagnosis of PNET of the urethra. He received combination chemotherapy ifosfamide and etoposide (IE) + vincristine, Adriamycin, and cyclophosphamide (VAC). In conclusion, PNET has to be considered in the differential diagnosis of a penile urethral mass in young patients.The health-care sector has been drastically overwhelmed in the wake of prevailing COVID-19 pandemic, hampering elective and emergency medical services alike. The geriatric population is especially affected in this regard as they are the ones who need access to health care services the most, and unfortunately, they are the ones with the highest risk of cross infection and mortality with SARS-COV-2. Lockdown and public restrictions have made the accessibility even harder. Telemedicine has emerged as a useful tool that avoids the risk of cross infection during the face-to-face consultation. Numerous guidelines have been made regarding the implementation of teleconsultations during this pandemic. Through this report, we describe the "beyond guidelines" emergency management of paraphimosis in an aged, bedridden male with comorbidities, through teleconsultation amid the COVID-19 pandemic.Urethral duplication (UD) in a female is a rare congenital anomaly. Although UD is commonly associated with other congenital anomalies of the urinary tract, its association with congenital megacystis with obstructive megaureter has not yet been reported. We present the case of a 9 year old girl child with complete sagittal duplication of the urethra associated with congenital megacystis and left obstructive megaureter.

Whole-body bone scintigraphy (WBBS) is considered to be the standard of care in the initial skeletal evaluation of patients with carcinoma prostate. Magnetic resonance imaging (MRI) is a potential alternative technique for detecting bone metastasis. The objective of this study was to compare the diagnostic performance of WBBS with a single-photon emission computed tomography-computed tomography (SPECT-CT) correlation of the suspicious WBBS lesions to the axial skeleton (AS)-MRI in diagnosing bone metastasis in patients with carcinoma prostate.

WBBS and AS-MRI were both performed during the initial skeletal evaluation in 35 patients of carcinoma prostate with the prostate-specific antigen (PSA) in the range of 10-50 ng/ml. Suspicious lesions on the WBBS were correlated on SPECT CT. The presence or absence of metastasis was determined by best valuable comparator. The validity parameters of WBBS and AS-MRI were computed and compared.

The sensitivity, specificity, positive predictive value, and negative predictive value of WBBS and AS-MRI for detecting patients with bone metastasis were 55.