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Background The supplementary motor area (SMA) is involved in planning of voluntary motor activities. Tumors in SMA usually present with seizures and, rarely, motor deficits. Postoperatively, these patients may develop SMA syndrome. Patients with SMA tumors usually undergo awake craniotomy along with neuromonitoring for maximal safe resection, and some of these patients tend to have residual tumor. Objective To completely excise the SMA region tumors under general anesthesia without causing any permanent neurological deficits. Methods We operated upon four patients with SMA region tumor under general anesthesia (GA) with direct electrocortical stimulation (DES). Motor-evoked potential was used to monitor corticospinal tracts through corkscrew or strip electrodes. Intraoperative MRI was done to assess the tumor excision. Results All four patients had complete resection of tumor and, postoperatively, all four developed SMA syndrome. All of them recovered completely over a period of time. Conclusion SMA tumors can be excised completely under GA with DES, thereby increasing progression-free survival. [ABSTRACT FROM AUTHOR]

Melanomas of vertebral body are usually metastatic lesions. Isolated vertebral body melanomas are rare may be due to unknown primary. Only threesuch cases havebeen reported in literature. We are reporting a 30-year-old female presented with progressive quadriparesis and bladder involvement. On evaluation, an extradural lesion at the C4-5 level with the destruction of C4 vertebral body and anterior in the prevertebral space seen with areas of blooming. The patient underwent surgery and biopsy was suggestive of melanoma. On further evaluation, we could find any other lesion in the body. The lesion can be either metastatic with unknown primary or primarily arising from vertebrae. Primary vertebral body melanomas are rare, surgical decompressions followed by immunotherapy may prolong the survival in this patients. [ABSTRACT FROM AUTHOR]

Sir, Spinal drop metastasis is common sequelae in high-grade like glioblastoma. In 2019, he presented with progressive spastic paraparesis and MRI dorsal spine revealed a contrast enhancing dorsally exophytic intramedullary mass lesion at D8D9 vertebral body level [Figure 1]c and [Figure 1]d. In literatureso far three cases have been reported on symptomatic spinal intramedullary metastasis (SIM) from low grade oilgodendroglioma.[[1]] We report an unusual case of a low-grade ODG, developed symptomatic intramedullary spinal cord metastasis after years. [Extracted from the article]

Presents a medical case of recurrent hemorrhagic pleural effusion in a patient with pancreaticopleural fistula. Medical history of the patient; Results of the chest x-rays; Pulmonary signs associated with acute pancreatitis.

An unusual case of bihormonal activity by squamous cell carcinoma of the esophagus is presented. It is a rare presentation of esophagus carcinoma because of the following reasons: 1. Synthesis of cortisteroids by esophageal carcinoma. 2. Pseudohyperparathyroidism caused by the same tumor. 3. Presentation of hypokalemic alkalosis as the initial manifestation and lack of specific gastrointestinal symptomatology of esophageal carcinoma. [ABSTRACT FROM AUTHOR]

Provides a summary of cases of postgastrectomy bezoars from June 1968 to June 1973. Methods used in diagnosing bezoar; Factors which contribute to the formation of phytobezoar in postgastrectomized patients; Symptoms presented by patients with bezoar.

In an infant presenting with a mass in the abdomen and non-bilious vomiting, duplication cyst needs to be considered in the list of differential diagnoses. Gastric duplication cyst is an uncommon occurrence in children. Diagnosis is based on clinical findings and imaging features. Surgical excision is safe and offers a complete cure. The literature recommends excision even in asymptomatic cases due to isolated reports of malignancy arising in the duplication cyst in later life. [ABSTRACT FROM AUTHOR]

Introduction: Vascular complications after orthotopic split liver transplantation in children result in significant post-operative complications.Materials and Methods: A review of children undergoing liver transplantation from 2004 to 2006 was undertaken. The data was obtained based on a proforma-based analysis.Results: Seven of 106 transplants were identified to have hepatic venous outflow obstruction (HVOO) of whom five were males and two were females. Median age at transplant was 8 years (range 3 years 4 months-15 years). The median donor-to-recipient weight ratio was 2.78 (range 0.97-6.15). ANASTOMOTIC TECHNIQUE: Hepatic vein-IVC in four, Hepatic vein-hepatic vein (HV-IVC) confluence in two and cavo hepatic in one. Ascites was the commonest post op manifestation of HVOO. Although Doppler USG was useful in identifying the venous outflow obstruction, venography confirmed the exact site of obstruction aiding in therapeutic dilatation. Three of seven cases had early onset (<1 month) while 4/7 had late onset (>1 month). 5/7 underwent venography and dilatation, of whom three are well and one is awaiting a repeat venography and dilatation. 2/7 died without intervention and 1/7 died in the waiting list for retransplantation.Conclusion: The diagnosis of HVOO requires a high index of suspicion, prompting early venography to manage HVOO successfully. Technical steps to avoid HVOO are to keep the hepatic vein-caval anastomosis short and wide with triangulation and to avoid graft rotation at the hepato caval junction. [ABSTRACT FROM AUTHOR]

We enrolled 911 children aged <12 years presenting to the trauma center of a tertiary-care hospital (over a period of 18 months) with history of injuries. Majority (582; 63.9%) of children had sustained injuries at home; 56 (6.1%) had severe injuries based on Pediatric Trauma Score. Of road traffic accidents victims (n=232), majority (40.5%) were two-wheeler pillion riders or pedestrians (31.9%). More Indian data are required and efforts are neded to prioritize injury prevention efforts in children. [ABSTRACT FROM AUTHOR]

Leiomyosarcoma of the anal canal is an uncommon neoplasm of the gastrointestinal tract. We report a 45-year-old lady with anal canal leiomyosarcoma. In view of its rarity, we report its presentation and management. In the setting of a recurrent tumor with high-grade histological appearance, local excision would be deemed unsafe. [ABSTRACT FROM AUTHOR]