iosr-JDMS   Volume-18 ~ Issue-10 ~ October-2019

Abstract: Purpose: To quantify the effects on the anterior segment morphometry and intraocular pressure (IOP) and timing of prescribing of glasses after uneventful small incision cataract surgery (SICS) with intraocular lens implantation in patients normal individuals. Materials and methods: Study included 93 eyes of 93 patients undergoing small incision cataract surgery, followed by posterior chamber intraocular lens implantations (PC IOL). The Pentacam rotating Scheimpflug camera measured the following changes that occurred in the anterior chamber: depth (ACD), angle (ACA), central corneal thickness (CCT).......

Key Words:ACD, ACA, CCT, SICS, Astigmatism

[1]. Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in anterior chamber angle width and depth after intraocular lens implantation in eyes with glaucoma. Ophthalmology 2000;107:698-703.
[2]. Shrivastava A, Singh K. The effect of cataract extraction on intraocular pressure. CurrOpinOphthalmol2010;21:118-22.
[3]. Uçakhan OO, Ozkan M, Kanpolat A. Anterior chamber parameters measured by the pentacam CES after uneventful phacoemulsification in normotensive eyes. Acta Ophthalmol2009;87:544-8.
[4]. Doganay S, Bozgul FP, Emre S, Yologlu S (2010) Evaluation of anterior segment parameter changes using the Pentacam after uneventful phacoemulsification. Acta Ophthalmol 88: 601-606.
[5]. Dooley I, Charalampidou S, Malik A, Loughman J, Molloy L, et al. (2010) Changes in intraocular pressure and anterior segment morphometry after uneventful phacoemulsification cataract surgery. Eye 24: 519-527.

Abstract: Postoperative pain is both distressing and detrimental for the patient. Both PEC (I & II) and ESP blocks seem potentially safer and effective nerve blocks for postoperative analgesia. This study was done to compare the intraoperative hemodynamic parameters, postoperative pain scores (VAS), total analgesic consumption and time of first rescue analgesic dose between the groups. PECS provides more beneficial outcomes in patients with breast surgeries in contrast......

Key words: Erector spinae, PEC (I & II), breast surgery, analgesia.

[1]. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug; 97(2):534–40.
[2]. Iohom G, Abdalla H, O‟Brien J, Szarvas S, Larney V, Buckley E, et al. The associations between severity of early postoperative pain, chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast surgery. Anesth Analg. 2006 Oct; 103(4):995–1000.
[3]. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006 May 13; 367(9522):1618–25.
[4]. De Pinto M, Dagal A, O‟Donnell B, Stogicza A, Chiu S, Edwards WT. Regional anesthesia for management of acute pain in the intensive care unit. Int J Crit Illn Inj Sci. 2015 Sep; 5(3):138–43.
[5]. Blanco R, Fajardo M, Parras Maldonado T. Ultrasound description of Pecs II (modified Pecs I): a novel approach to breast surgery. Rev Esp Anestesiol Reanim. 2012 Nov; 59(9):470–5.

Abstract: Macular hole management is one of the most challenging clinical retinal disorders in Ophthalmology with varying percentages of anatomical and visual success rates. We herewith report our clinical experience of managing idiopathic and nonidiopathic types of macular holes through this article with comparable success rates.

Key words: Macular hole, vitrectomy, OCT

[1]. Ho AC, Guyer DR, Fine SL: Macular hole. Surv Ophthalmol. 1998 Mar-Apr;42(5):393-416. Review.
[2]. la Cour M., Friis J. Macular holes: classification, epidemiology, natural history and treatment. Acta Ophthalmologica. 2002;80(6):579–587. doi: 10.1034/j.1600-0420.2002.800605.
[3]. Jonson RN, Gass JD. Idiopathic macular holes: Observation, stages of formation and implications for surgical intervention. Ophthalmology 1988; 95:917-924.
[4]. Kelly NE, Wendel RT : Vitreous surgery for idiopathic macular holes : Results of a pilot study. Arch Ophthalmol 109:654-659, 1991.
[5]. Kelly NE, Wendel RT : Vitreous surgery for macular holes. Ophthalmology 1993; 100:1671-1676.

Abstract: Purpose: Outcomes of idiopathic macular holes surgery with SF6 gas and role of OCT. Methods : Prospective pre-post operative hospital based case series of 26 eyes of 26 patients with stage 2,3 and 4 macular holes that underwent pars plana vitrectomy, BBG-assisted internal limiting memebrane (ILM) peel, sulfur hexafluoride (SF6) gas temonade and 2 days face-down positioning. Results: : The anatomical closure rate was 84.61% (22 of 26 eyes) and Visual improvement at 6 weeks 0.152±0.078 (SD) decimal from preoperative BCVA 0.109±0.042 (SD) decimal was found to be significant (p=0.001) ; OCT enabled 53.85% (14 of 26 eyes) macular hole closure on second postoperative day with a single operation.........

Key words: Macular hole (MH), ILM, SF6gas, OCT(Optical coherence tomography)

[1]. Ho AC, Guyer DR, Fine SL: Macular hole. SurvOphthalmol. 1998 Mar-Apr;42(5):393-416. Review.
[2]. The Eye Disease Case–Control Study Group. Risk factors for idiopathicmacular holes. Am J Ophthalmol 1994;118:754–61.
[3]. Evans JR1, Schwartz SD, McHugh JD, Thamby-Rajah Y, Hodgson SA, Wormald RP, Gregor ZJ.Systemic risk factors for idiopathic macular holes: a case-control study.Eye (Lond). 1998;12 ( Pt 2):256-9
[4]. Gass JD: Reappraisal of biomicroscopic classification of stages of development of a macular hole. Am J Ophthalmol 119:752-759, 1995.
[5]. Kelly NE, WendelRT : Vitreous surgery for idiopathic macular holes : Results of a pilot study. Arch Ophthalmol 109:654-659, 1991..

Abstract: When it was discovered that Down's Syndrome was in fact caused by chromosomal abnormality, research was begun to see how far the hand could be used as a guide to diagnosing other chromosomal defects and dermatoglyphic analysis soon became referred to as 'the poor man's karyotype'. The present study was undertaken to study in depth of the lip prints of different individuals with Down syndrome, to study the lip print pattern of Down's syndrome subjects, their family members, compare the lip print pattern of Down's syndrome subjects and their family members with normal subjects and find any correlation, if any. Three groups were formed, first comprising of normal subjects as a control group, second of Down's syndrome individuals and third of family......

Key words: Downs Syndrome, Lip print, Cheiloscopy

[1] Cummins H. Dermatoglyphic stigmata in downs syndrome imbeciles. Ibid. 1939; 73: 407.
[2] Luntz L. History of forensic dentistry. Dental clinics of North America. 1977; 21(1): 47-67.
[3] Kasprazak J. Possibilities of cheiloscopy. Forensic Science International. 1990; 46: 145-151.
[4] Tsuchihashi Y. Studies on personal identification by means of lip print. Forensic Science International. 1974; 3: 233-248.
[5] Noboru K., Yukiko Y., Nobuaki K., Koji K., Masyuki K., Koichi M., et al. Study on abnormalities in the appearance of finger and palm prints in children with cleft lip, alveolus and palate. J Max Fac Surg, 1986; 14: 74-82.

Abstract: Disability‟ has a great impact on the patient and the family with gross implication on the economy with need of specialist care and neuro-rehabilitation and palliative care. This leads to stress over need of special care givers and training for the same urging the need of care methods. One of the most important aspects of patient care is the nutritional requirement. Critically ill patients are at a constant risk of malnutrition. Trauma and inflammation induce stress-related catabolism, and drug-induced adverse effects may reduce appetite or increase nausea and vomiting(1). Patient management in the intensive care unit (ICU) may also interrupt feeding routines(2,3,4) In particular, certain types of dietary.........

[1]. Lewis SR, Schofield‐Robinson OJ, Alderson P, Smith AF. Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No.: CD012276.

[2]. Abdulmeguid AM, Hassan A. Enteral versus parenteral nutrition in mechanically ventilated patients. NeurologiaCroatica 2007;56:15‐24.

[3]. Abrishami R, Ahmadi A, Abdollahi M, Moosivand A, Khalili H, Najafi A, et al. Comparison the inflammatory effects of early supplemental parenteral nutrition plus enteral nutrition versus enteral nutrition alone in critically ill patients. Daru 2010;18(2):103‐6. [4]. Altintas ND, Aydin K, Türkoğlu MA, Abbasoğlu O, Topeli A. Effect of enteral versus parenteral nutrition on outcome of medical patients requiring mechanical ventilation. Nutrition in Clinical Practice: Official Publication of the American Society for Parenteral and Enteral Nutrition 2011;26(3):322‐9.

[5]. Baranauskas G. Pain-induced plasticity in the spinal cord. In: Shaw CA, McEachern J, editors. Toward a Theory of Neuroplasticity. Philadelphia, PA: Psychology Press; 2001. pp. 373–386.

Abstract: Background- Propofol has become a most popular intravenous agent. The most common problem with administration of i.v propofol is pain at the injection site. On an average, 70-85 % of patients report pain on injecting propofol. Aim- To study the incidence and severity of pain due to propofol injection. Primary objective - To compare pain between Propofol LCT and Propofol-MCT/LCT. Secondary objective- To compare heart rate and mean arterial pressure between Propofol LCT and Propofol-MCT/LCT. Material and methods- The study was conducted at Indira Gandhi Institute of Medical Sciences, Patna after approval by Institutional Ethical Committee. Drugs used for study- Inj.1% LCT........

[1]. Scott Rp, Saunders D, Norman J. Propofol: clinical strategies for preventing the pain of injection. Anaesthesia 1988 43: 492-4.
[2]. Doenicke AW, Roizen MF, Rau J, Kellermann W, Babl J. "Reducing pain during propofol injection: the role of the solvent" AnesthAnalg. 1996 Mar; 82 (3): 472-4.
[3]. Huang YW, Buerkle H, Lee TH. Effect of pretreatment with ketorolac on propofol injection pain ActaAnaesthisiool. Scand. 2002;46:1021-4.
[4]. Pireard P; Tramer Mr. Prevention of pain on injection with propofol:a quantitative systematic review. AnesthAnaleg 2000; 90(4) 963-9.
[5]. Lilley EM, Isert PR, Carasso ML, Kennedy RA. The effect of the addition of lignocaine on propofol emulsion stability. Anaesthesia. 1996;51:815-8.

Abstract: Background and Aims: About 5% of all trauma admissions and 30-40% with significant blunt injury abdomen are known to have different grades of liver injury. Non operative management of low and moderate grade liver injury is being preferred nowadays. The present study evaluates the experience of non operative management of liver trauma at GMKMCH, Salem. Materials and methods: A prospective study of 40 patients with isolated low and moderate grade (Grade I –IV) blunt liver trauma admitted at trauma ward at GMKMCH, Salem for a period of 1 year from September 2018 – August 2019 were taken into study and their outcome were analysed.........

Keywords: Blunt liver trauma, low and moderate grade, non operative management

[1]. Boone DC, Federie M, Billiar TR, Udekwu AO, Peitzman AB (1995) Evolution of management of major hepatic trauma: identification of patters of injury J Trauma 39:344-350
[2]. Anderson R, Alwmark A, Hasselgren P-O, Bengmark S (1989) management of liver trauma – a non operative approach in selected cases. Surg Res Comm 4:293-297.
[3]. Andersson R, Alwmark A,Gullstrand P, Offenbarti K, Bengmark S.(1986) Non operative treatment of blunt trauma to liver and spleen. Acta Chir Scand 152:739-741.
[4]. Sherman HF, Savage BA, Jones LM, Barrette RR, Latenser BA, Varcelotti JR et al. (1994) Nonoperative management of blunt hepatic injuries: safe at any grade? J Trauma 37:616-621.

Abstract: Introduction- clinical presentation as chronic Maxillary sinusits in ENT OPD is very common. The clefts and the narrow space in the lateral wall of nose osteomeatal complex plays a key role in pathophysiology of sinuses. Sinusitis is the disease secondary to impaired drainage of sinuses leading to inflammation. our study has taken patients of chronic maxillary sinusitis categorized on the basis of duration of disease more than 8 weeks and acute exacerbation or recurrent sinusitis 3-4 episodes per year lasting for 2 weeks duration. Diagnosis of sinusitis is based on clinical features, diagnostic nasal endoscopy and Radiological evidences. Failing with Medical treatment we treated these cases with Antral Wash Out and Middle Meatal Antrostomy. We compared the outcome of two surgical options. The outcome of these procedure compared for early relief and recurrence after surgery. our Aim of study is to find out the usefulness of antral Wash out at present in the era of Functional endoscopic sinus surgery and the objective is to compare the out comes of antral wash out and Middle Meatal Antrostomy..........

Keywords- Chronic Maxillary Sinusitis, Antral Wash Out, Middle Meatal Antrostomy (MMA.

[1]. John C Watkinson ,Reymond W Clarke Scott-Brown's Otorhinolaryngology Head &Neck Surgery, vol-1, Rhinosinusitis. Carl Philpott. 1028-1029, Medical management. Claire Hopkins. 1058-1068, Surgical management. A Simon Carey & Raymonds Sacks. 1071-1078. Eighth's Edition 2018, CRC Press.
[2]. PL Dhingra ,chronic rhinosinusitis, proof pucture, Diseases of Ear, Nose and Throat & Head and Neck Surgery-Seventh edition 2018 India Elsvier publishers 217-226, 465-466.
[3]. Messerklinger W Endoscopy of nose.Monatsschr Ohrenheilkd Laryngorhinol. 1970;104:451-4546.(Pubmed)[Google scholar]
[4]. Salvatore Puglisi, salvatore privitera ,Luigi Maiolino . Bacteriological findings and Antimicrobial resistance in odontogenic and non odontogenic chronic maxillary sinusitis. Journal of medical microbiology (2011) 60, 1373-1359.
[5]. Annika Luukkainen, Endoscopic sinus surgery with antrostomy has better early endoscopic recovery in coparison to the ostium-preserving technique. ISRN Otolaryngology (2012) 13/ 1-13.

Abstract: INTRODUCTION: Snakebite is a major public health problem throughout the world especially in tropical and sub-trophical countries. Snake bite cellulitis is the most feared complication. In addition to the anti snakevenom ,fasciotomy helps in improving the outcome of the patient. Hence early identification and treatment plays major role in reducing the morbidity and mortality. AIM AND OBJECTIVES: To study the incidence of compartment syndrome, fasciotomy , wound debridement and amputation rate. 50 patients admitted with signs of cellulitis secondary to snakebite were taken up for the study from January 2019 to June 2019........

KEY WORDS: Snake Bite, Asv, Compartment Syndrome, Fasciotomy.

[1]. Jiann-RueyOng, MD;Hon-Ping Ma Et al. " Snake bites" Ann Disaster Med, 2004, Vol 2 Suppl 2, 80-88.
[2]. Warrell DA. The clinical management of snake bites in the Southeast Asian region. South East Asian J Trop Med Public Health 1999;30:1-85
[3]. David A Warrell : WHO Guidelines for the management of snake-bites For South East Asian Countries. 2010
[4]. Silva De A. Snake bites in Anuradhapura District. Snake.1981;13:117-130
[5]. Kalantri S, Singh A, Joshi R, Malamba S, Ho C, Ezoua J, et al.; Clinical predictors of inhospital mor

Abstract: Medical education in India is faced with some unique challenges. One, there is gross disparity in terms of burden of disease versus number of qualified doctors in India. Secondly, there is also discussion on the quality of medical education. Many physicians who are graduated from India migrate to different parts of the world making a global impact. Considering this, reforms in medical educationhas been a topic of discussion for several years. The objective of this reform is to generate medical graduate who can effectively tackle the health situation in India and at the same time being globally relevant. Recently, Medical Council of India (MCI) has released a new curriculum "Competency Based medical Education" The implementation of this curriculum has just started from August 2019. In this article, we discuss our perspective about the new medical curriculum.

Key words: Competency Based medical Education, India, Medical Graduate

[1]. Anshu, Supe A. Evolution of medical education in India: The impact of colonialism J Postgrad Med. 2016 ;62: 255–259. [2]. Chandramohan P. Medical education in India at crossroads: Issues and solutions. Arch Med Health Sci 2013;1:80-4
[3]. Gujar N, Jadhav K. Medical education in India - An overview. J Med Sci 2016; 9:76-78
[4]. Negandhi H, Sharma K, Zodpey SP. History and evolution of public health education in India 2012;56:12-16
[5]. Shrivastav JB. New Delhi: Ministry of Health and Family Welfare, Govt of India; 1975. [Last accessde on 2019 October 2]. Shrivastav Committee Report: Health Services and Medical Education – A Programme for Immediate Action. Available from https://www.nhp.gov.in/sites/default/files/pdf/Srivastava_Committee_Report.pdf

Abstract: Background: The age at menarche as well as other changes that occur during puberty are actually due to major and specific hormonal changes that occur in the body at puberty. The purpose of this study was to assess factors affecting the age at menarche in this environment, and obtain an actual reliable data on the age at menarche. Methods: A cross sectional study was carried out in Yenegoa, Bayelsa state. Random sampling method was used and Data were collected using a self-administered structured questionnaire on menstruation. This study investigated the age at menarche of 400 secondary school girls between the ages of 10-20 years. This research was carried out under the supervision of the research.........

Key: Socioeconomic class, Stress, Diet

[1]. Adesina FA, Peterside O. Age at menarche and body massindex (BMI) among adolescent secondary school girls inPort Harcourt, Nigeria. J Dent Med Sci 2013; 3(5):41-46.
[2]. Al-Agha, A.E., Hadadi, A.A., and Tatwany, B.O. (2015). Early puberty and its effect on height in young Saudi females: A cross sectional study. Pediatrics and Therapeutics.Volume 5, issues 1.
[3]. Al-Awadhi N, Al-Kandari N, Al-Hassan T, AlMurjan D,Salhah A, Al-Taiar A. Age at menarche and its relationshipto body mass index among adolescent girls in Kuwait. BMCPublic Health 2013; 13:29.
[4]. Arteria MD, Hennerberg M. Why did they lie?Socioeconomic bias in reporting menarcheal age. Ann HumBiol 2000; 2:561-569.
[5]. Berkey C.S., Gardner J.D., Frazier A.C. and Colditz G.A., 2000. Relation to childhood diet and body size to menarche and adolescent growth in girls Am. J.Epidemiol., 152:446-452.

Abstract: Objective: To compare efficacy and complication rates of vaginal misoprostol in termination of first and second trimester missed abortion cases. Materials and Methods: Seventy five women in age group between 18-38 years were recruited for the study. 800 μg of vaginal misoprostol was kept in the posterior fornix for all the women. If the patient did not abort after 24 hours, the similar dose was repeated followed which the patient was treated as failure and surgical evacuation was carried out. The subjects were then followed for completion of abortion, need for suction evacuation, vaginal bleeding and side effects if any........

Key-words: Missed abortion, vaginal misoprostol, vaginal bleeding, first trimester, second trimester.

[1]. Jukovic, D., Ross, J. A. & Nicoladies, K. H. Expectant management of missed miscarriage. Br J Obstet Gynaecol. 1998;105: 670–671.
[2]. Huchon, C. et al. Pregnancy loss: French clinical practice guidelines. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016;201: 18–26.
[3]. Kushwah, D. S., Kushwah, B., Salman, M. T. & Verma, V. K. Acceptability and safety profile of oral and sublingual misoprostol for uterine evacuation following early fetal demise. Indian J Pharmacol. 2011;43: 306–310.
[4]. Chia, K. V. & Ogbo, V. I. Medical termination of missed abortion. J Obstet Gynaecol. 2002;22: 184–186.
[5]. Petrou, S., Trinder, J., Brocklehurst, P. & Smith, L. Economic evaluation of alternative management methods of first-trimester miscarriage based on results from the MIST trial. BJOG. 2006;113: 879–889.

Abstract: Emulgel have emerged as a extensively used drug delivery system for the delivery of hydrophobic drugs. The objective of the study was to formulate and evaluate emu gel of oxaprozin, NSAIDs using a gelling agent i.e. carabapol 940 . To enhance the permeability , mentha oil and clove oil were used . Separately, emulsion and gel were prepared & mixed together to provide emulgel formulations. The viscosity, spreading coefficient, bioadhesion, skin irritation tests and in vitro drug release tests of emulgel were evaluated. Formulation F2 & F4 found comparable analgesic and anti inflammatory activity with marketed ibuprofen gel. So emu gel of oxaprozin can be posses an effective anti inflammatory and analgesic activity.

Keywords:- Oxaprozin, emulgel, NSAIDs,

[1]. Rachit khullar, Deepinder kumar, Nimrata Seth, Seema saini, a research article on formulation and evaluation of mefanimic acid emulgel for topical delivery, 2011
[2]. SEARLE Company FDA approved, Description paper about Daypro tablet 600 mg2016
[3]. Verma Sachin, Khusboo, Mishra ankita,Review article on emulgel 2017, Goel institute of pharmacy and sciences,Lucknow,U.P. India

Abstract: Vertebral-medullary injury named also traumatic spinal cord injury (TSCI) is a neurological disorder consisting of damage to the spinal cord. As a result, the cord`s normal anatomic, sensory or motor functions change. It is a major life event that can lead to physical disability, which also has a great impact on the psychological function of the persons involved, altering their quality of life. The most important aspect of clinical care for the TSCI patient is preventing complications and disabilities related to the medical condition, such as anxiety. This article highlights the importance of behavioural therapy including relaxation techniques, in decreasing the anxiety level related to the medical condition.

[1]. The Free Online Medical Dictionary by Farlex, www.thefreedictionary.com
[2]. Narenthiran, G., (2007). Spine Scales. Surgicalneurology.org
[3]. American Spinal Injury Association (2000). International Standard for Neurological Classification of Spinal Cord Injury, revised ed. Chicago, III;1-23
[4]. Lim S-W, Shiue Y-L, Ho C-H, Yu S-C, Kao P-H, Wang J-J, et al. (2017) Anxiety and Depression in Patients with Traumatic Spinal Cord Injury: A Nationwide Population-Based Cohort Study. PLoS ONE 12(1): e0169623. https://doi.org/10.1371/journal.pone.0169623
[5]. Bryce TN, Budh CN, Cardenas DD, Dijkers M, Felix ER, Finnerup NB et al (2007). Pain after spinal cord injury: an evidence-based review for clinical practice and research. Report of the National Institute on Disability and Rehabilitation Research Spinal Cord Injury Measures meeting. J Spinal Cord Med;

Abstract: Portal cavernoma, also called cavernous transformation of the portal vein, consists of a network of venous channels, which replaces a previously stenosed or occluded portal vein. Portal cavernomacholangiopathy (PCC) is defined as abnormalities in the extrahepatic biliary system including the cystic duct and gallbladder with or without abnormalities in the 1st and 2nd generation biliary ducts in a patient with portal cavernoma. For the diagnosis of PCC to be established, the following criteria should be fulfilled - presence of a portal cavernoma, typical cholangiographic changes on ERC or MRCP and absence of other causes of these biliary changes like bile duct injury, primary sclerosingcholangitis, cholangiocarcinoma etc (1). PCC manifests as biliary pain, jaundice, cholestasis or cholangitis along with derangement of liver functions (2)..........

[1]. Radha K. Dhiman, Vivek A. Saraswat; Portal CavernomaCholangiopathy: Consensus Statement of a Working Party of the Indian National Association for Study of the Liver; J ClinExpHepatol. 2014 Feb; 4(Suppl 1): S2–S14.
[2]. Kumar M, Saraswat V; Natural History of Portal CavernomaCholangiopathy; Journal of clinical and experimaentalhepatologyFebruary 2014Volume 4, Supplement 1, Pages S62–S66 x
[3]. Sarin SK, Guptan RC, Malhotra S. Increased frequency of gallstones in cirrhotic and non-cirrhotic portal hypertension.J Assoc Physicians India. 2002 Apr;50:518-22.
[4]. Machado NO. Laparoscopic cholecystectomy in cirrhotics.JSLS. 2012 Jul-Sep;16(3):392-400.
[5]. Bhatia P, John S, Kalhan S, Khetan M. Primary laparoscopic cholecystectomy in patients with portal cavernoma and non-obstructive portal biliopathy: Two case reports. J Min Access Surg 2014;10:161-2