|LESSER INVASIVE SURGERY FOR PECTUS EXCAVATUM|
In a child with pectus excavatum, the chest wall curves sharply inward and presses against the heart and lungs leading to dyspnea on exertion and disfigurement.
Traditional surgery includes cutting the child's sternum, and pushing it out to expand the chest wall. It is effective in restoring full breathing capacity and correcting an odd-shaped appearance. But occasionally the repositioned sternum either protrudes too far or sinks back requiring another operation.
Now, in a new, minimally invasive modification of the surgery, called the Nuss procedure, a curved stainless steel bar is inserted beneath the sternum through two small incisions on the side of the chest and stitching the bar to the ribs. The bar then pushes the sternum outward and over a two-year period remolds the chest wall. At the end of the process, surgeons slide it out. Since the surgery is minimally invasive and avoids cutting through the sternum, the likelihood of the chest's falling back down is minimized. The Nuss procedure takes 90 minutes compared with the four-hour open surgery. Hence, recovery is faster and less painful for children.
Last updated on 13-02-2003
Pediatric Oncall Journal
Syrup formulations of antiretrovirals especially zidovudine and nevirapine are in short supply due to decreased production. How to give prophylaxis to the babies to prevent vertical transmission of HIV_?
Pulverise the adult tablet and give
Do not give prophylaxis to the babies
On humanitarian grounds, the production should be maintained
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