OBJECTIVES Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. SETTING We conducted a systematic review of r...

Aneurysm of the sinus of Valsalva that causes dissection of the interventricular septum is an extremely rare entity. In this report we describe a case of aneurysm of the sinus of Valsalva dissecting into the interventricular septum, from the base to mid septum, after aortic valve replacement. After the diagnosis was made by transthoracic echocardiography and magnetic resonance imaging, the pati...

Background Minimally invasive aortic valve replacement (MIAVR) was first described in 1996 as an alternative to median sternotomy for AVR. Its uptake has been sporadic in cardiac surgery units in the UK. It remains unclear and somewhat controversial whether it has superior patient outcomes over conventional sternotomy. This survey aims to explore the reason for the low uptake by consultant surg...

Estrogens are crucial for the proper functioning of genitourinary tract. Hypoestrogenism related to menopause could be linked to numerous disturbances of lower urinary tract. However, the results of most well designed clinical studies do not support use of estrogen or hormone replacement therapy for the treatment of genitourinary symptoms. According to evidence base medicine stress urinary inco...

Fibrinogen is fundamental to hemostasis and falls rapidly in trauma hemorrhage, although levels are not routinely measured in the acute bleeding episode. Prompt identification of critically low levels of fibrinogen and early supplementation has the potential to correct trauma-induced coagulation and improve outcomes. Early estimation of hypofibrinogenemia is possible using surrogate markers of ...

We have recently reported the discovery of an entirely new category of potent antiviral agents based on novel deoxynucleoside analogues with unusual fluorescent bicyclic furo base moieties. To probe structure-activity relationships and to seek to optimize the properties of the lead compounds, we prepared pyrro analogues of the furo systems. We herein report the synthesis, characterization and a...

introduction: caustic ingestion is responsible for a spectrum of upper gastrointestinal tract injury from self-limited to perforation. this study conducted to evaluate clinical characteristics as well as surgical outcomes in patients with caustic ingestion.   materials and methods: between nov1993 to march 2011, 14 adults with a clinical evidence of corrosive ingestion were admitted into our in...

background: vitamin d (vit d) is linked to various conditions including musculoskeletal, metabolic and   cardiopulmonary diseases. however, it is not clear whether correction of vit d deficiency exerts any beneficial effect in patients with pulmonary hypertension. methods: this study was a prospective uncontrolled longitudinal study. patients with pulmonary hypertension and vit d deficiency wer...

adrenal insufficiency is a life-threatening disorder which must be treated with glucocorticoid replacement and needs permanent dose adjustment during patient's different somatic situations. insufficient glucocorticoid doses result in adrenal crisis and must be treated with intravenous hydrocortisone. the patient was known with adrenal insufficiency and was treated optimally with fludrocortisone...