ABSTRACT
Decompression illness (DCI) has been deemed a rare clinical entity in different diver populations. The incidence of DCI varies from 0.010% to 0.095% per dive. The DCI is a collective term including two disorders. The first one is caused by evolution of bubbles from dissolved inert gas; the second one is caused by introduction of air to the systemic circulation by pulmonary barotrauma. The gold standard treatment for DCI is recompression in a hyperbaric chamber with administration of hyperbaric oxygen during the treatment. We report a case of a 46-year-old technical diver complained decrease motor and sensory function of lower limbs 50 minutes after diving mission had been completed. He had received first aid 100% oxygen and sought medical attention right after the accident. After hyperbaric chamber treatment, the lower limb muscle power recovered from 2/5 to 3/5. He was discharged from hospital after rehabilitation for 3 months when he could walk by himself. After follow up for 12 years, his lower limb muscle power had no improvement while he complained increase of walking instability. The MRI scan discover thoracic spinal cord atrophy. The side effect of spinal cord atrophy induced by DCI has not been reported before.

ABSTRACT
Background: Venous thromboembolism (VTE) is the leading cause of morbidity and mortality worldwide among patients undergoing surgical procedures. This study aimed to determine the incidence, predictors, and outcome of VTE among patients undergoing major surgical procedures at Bugando Medical Centre (BMC). Methods: A descriptive longitudinal study involving 381 participants was conducted from February 2020 to July 2020 at BMC. Patients with a high modified Caprini and modified Wells score underwent doppler ultrasound and computed tomography pulmonary angiogram to confirm presence of VTE. Post mortem was performed on participants who succumbed to death prior to these investigations. Categorical variables significance calculated using Chi-square and Fisher’s exact tests. Cox regression analysis was used determine the predictors. Kaplan-Meier survival curve used to depict the occurrence of VTE. Results: The cumulative incidence of VTE was 11.8%. Age ≥45 years, body mass index ≥25, hypertension and prolonged immobilization were significant predictors of VTE. Around 43.0% (n=164) were postoperatively classified as having a high risk of developing VTE. Of these, 27.7% (n=45) developed VTE (p<0.001) of which 14 patients died resulting in a mortality rate of 31.1%, and the mortality was significantly associated with males (p=0.013). Only 17.7% (n=29) of high-risk patients received VTE prophylaxis, however, prophylaxis was protective against development of VTE (p=0.023). Conclusion: Venous thromboembolism is not uncommon among postoperative patients and is associated with high mortality rate. Appropriate VTE screening and prophylaxis is of paramount importance in order to lower VTE morbidity and mortality.

ABSTRACT
Informed consent is a process for getting permission before conducting a healthcare intervention on a person, for conducting some form of research on a person, or for disclosing a person's information. The detailed analysis of the informed consent form yields following results. Out of a total of 50 form analysed, only 15(30%) were found to be completely filled and correct. A Total of 10(20%) certificates contained major errors and 25(50%) contained minor errors. 30(60%) forms contained both major and minor errors.

ABSTRACT
Primary or essential hyperhidrosis is a disorder characterized by excessive, chronic, sweating acquired during rest, unrelated to the need of heat loss of the body. It can affect one or more areas of the body, occurring predominantly in the hands, armpits, feet, head and also in the inguinal region. Palmar hyperhidrosis is a condition that has important consequences on the quality of life of individuals, causing social embarrassment and difficulties in school and professional environments. There are a variety of treatments available and the individual choice of the best option for each patient can help in improving their quality of life. Endoscopic thoracicsympathetectomy is a safe and effective method used in the management of hyperhydriosis of the palms after all other non surgical modalities have been tried.

ABSTRACT
Background: Sigmoid volvulus is among the common causes of intestinal obstruction worldwide. It usually occurs in elderly patients and rarely reported in children and young adults. Chronic form of sigmoid is a rare surgical condition in which patient can present with equivocal symptoms and signs of intestinal obstruction. Case presentation: Case 1: A 22 year old male university student presented with a long-standing history of abdominal discomfort and passage of loose stool. He occasionally experienced constipation and abdominal distension whenever he ate carbohydrate rich food. On admission at BMC, he had abdominal distension and hypertympanic percussion note on abdominal examination. Abdominal x-rays revealed features of sigmoid volvulus and patient was later prepared for elective laparotomy. Resection of a redundant sigmoid colon and primary anastomosis was done. Case 2: A 17 year old male referred from a peripheral district hospital with six months history of painless abdominal distention. During this period, he suffered from frequent attacks of early satiety and occasional constipation. On admission at BMC, his abdomen was distended with hypertympanic percussion note and exaggerated bowel sounds on abdominal examination. Abdominal x-ray and barium enema revealed features of sigmoid volvulus. Sigmoidectomy followed by primary colorectal anastomosis was done. Conclusion: Sigmoid volvulus should be considered as a differential diagnosis when attending young patients with a long-standing history of abdominal distension and constipation.

ABSTRACT
Anaplastic thyroid carcinoma is one of the rare tumors of the thyroid gland. Its prevalence is about 2% to 5% in our environment. It has a characteristic of growing rapid. Typically develops from well differentiated thyroid carcinoma or goiter. Its the leading with worsest prognosis among the thyroid carcinoma. In this case we report of a female patient 77yrs old with a history of anterior neck swelling over a period of 30yrs.The swelling is ulcerative with pus discharge over the tip point. One of the investigations of fine needle and aspiration cytology was done and reported to have features suspicious of malignancy. Total thyroidectomy was done and the spacimen taken for histopathology. We report one such case with discharging sinus over the involved skin which is rare. Only one article is publish in relation to skin involvement and the type of thyroid malignant was papillary thyroid malignancy.

ABSTRACT
Rhabdomyosarcoma (RMS), is a neoplasm of skeletal muscle in origin, is the second most common soft tissue sarcoma encountered in childhood after osteosarcoma. The common sites of involvement are the head and neck region, genitourinary tract, retroperitoneum, and to a lesser extent, the extremities. Site predilections is the oral cavity which are soft palate, maxillary sinus and alveolus, posterior mandibular region, cheek and lip, and sometimes tongue. RMS is highly malignant tumor with extensive local invasions and early hemorrhagic and lymphatic dissemination. We present a case of 25yrs old lady came to our emergency depatment with history of swelling of the right side of the face and protrusion of the right eye.Patient was also pregnant at 38weeks of gestation. C/s was done and later on the lateral rhinotomy with extened weber fergusson was done followed by radiochemotherapy.