Kauverian Medical Journal

Analysis of femoral neck fracture in octogenarians and its management: A retrospective cohort study in Kauvery Hospital, Cantonment, Tiruchirappalli

S. Yogesh — 2024-06-25

The six million populations of people in India above eighty years in 2013 will rise up to thirty million by 2050[1]. The very elderly suffer from co-morbidities like osteoporosis, medical problems, financial problems and most of them are dependent on others for
their care. Falls are the fifth leading cause of death in elderly [2]. 5 % of those elderly people who have falls have major fractures
like fracture neck of femur, distal radius fracture, and vertebral fractures.

Cardiac surgery in an octogenarian Indian population

Venkatesa Kumar Anakaputhur Rajan — 2024-06-25

Background: With increase in the elderly population, octogenerians requiring cardiac surgery have also increased in India. Previous literature suggest that surgical intervention performed in selected patients with preserved physical and mental health can provide acceptable outcomes with good quality of life.

Aim: This study aims to analyze the immediate postoperative outcomes of cardiac surgery in octogenarians.

Result: The Octogenarians (n=21) who underwent cardiac surgery between January 1st, 2017 and July 31st, 2023, were included. The mean age was 81.76 ± 1.76. The incidence of left main coronary artery disease, carotid disease, peripheral vascular disease and history of recent acute coronary syndrome were 13 (65%), 5 (23.8%), 6 (28.6%) and 15 (71.4%), respectively.

Discussion: Mostly, patients underwent elective procedure (n=20, 95.23%) except one patient (4.76%) who underwent emergency Bentall procedure for acute type A dissection. The need for prolonged ventilation, intra-aortic balloon pump usage and pacemaker implantation were 4.76% (n=1), each. Incidence of acute kidney injury was 2 (9.52%), but none of the patients required dialysis. The mean postoperative ICU and hospital stay were 2 and 7 days, respectively. The expected (EuroSCORE II) versus observed in-hospital mortality was 6.25% versus 9.5% (O/E = 1.52).

Conclusion: We conclude that cardiac surgery in Indian octogenerians is safe in selected patients.

A non-randomized retrospective study on the management of pediatric septic arthritis

G. Krupakaran — 2024-06-25

Septic arthritis results from presence of microbial agents in the joint space. Though uncommon, septic arthritis must be ruled out in any child presenting with a painful joint. Septic arthritis is a true orthopedic emergency and a delay in diagnosis or treatment may lead to irreversible damage to the joint.

Severe heat stroke with dyselectrolytemia—Intravascular treatment approach

Karthi Mahadevan — 2024-06-25

Heatstroke is a severe heat-related illness that involves an elevation in body temperature greater than 40°C. It is a life threatening condition resulting from prolonged exposure to high temperatures leading to failure of body’s thermoregulatory mechanisms. The patient may have clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures that are brought on after strenuous physical exertion or exposure to hot weather.

Cardiac Arrhythmias in the ER setting

Suhas Sagar N U — 2024-06-25

Cardiac arrhythmias are deviations from the normal electrical activity of the heart, leading to irregular heart rhythms. They can arise from abnormalities in impulse generation or conduction within the heart's electrical system. Arrhythmias are categorized based on their origin (atrial, ventricular, or supraventricular), rate (tachyarrhythmias for fast rate, bradyarrhythmias for slow rate), rhythms (regular and irregular). Diagnosing arrhythmias involves electrocardiography (ECG). Management strategies include medications, cardioversion or defibrillation. Understanding the pathophysiology and classification of arrhythmias is fundamental for clinicians to provide effective patient care