Amputation is the loss or removal of a body part such as a finger, toe, hand, foot, arm or leg. It can be a life changing experience affecting your ability to move, work, interact with others and maintain your independence. Continuing pain, phantom limb phenomena and emotional trauma can complicate recovery.
The surgeon can take steps during the amputation surgery to address the nerves that carry sensations back to the brain that affect pain and phantom sensations. These steps do not eliminate the problems but can reduce the overall risk of them happening and the extent to which they occur. The nerve procedures may also be performed later for patients who have already had an amputation and are still experiencing severe nerve pain.
Uncontrolled pain can be a complication of any surgery, and the amputation team works hard to make sure pain is manageable. Pain control regimens may begin before surgery if possible. A peripheral nerve block might be necessary to control pain and phantom limb sensations.
The initial pelvic ultrasound showed no sonographic evidence of intrauterine or tubal gestation. The left ovary was surgically absent however the right ovary was enlarged with complex cystic mass with solid components measuring 9.5 × 6.6 cm. The work-up for false positive elevation of β-hCG including serial dilutions, incorporation of animal serum and outside institutional validation testing for β-hCG heterophile antibody, was negative. Therefore, the β-hCG elevation was not thought to be related to a phantom hCG.
Phantom hCG is a phenomenon first described in 1998 by Laurence Cole, Ph.D., where patients have persistent mild elevations of β-hCG, occasionally following miscarriage. The elevated β-hCG often falsely interpreted and misleads physicians to evaluate or incorrectly treat patients with cytotoxic agents for trophoblast disease (Cole, 1998). Heterophilic antibodies against mouse, goat, rabbit, cow, horse, or sheep antigens can interfere with two-site immunoassays by creating complexes between the two anti-β-hCG antibodies without β-hCG being present. This leads to a false-positive result (Vladutiu et al., 1982). People can develop heterophilic antibodies by exposure to the serum, tissue, or other antigens of nonhuman species. The incidence of these antibodies in the general population is uncertain. Heterophilic antibodies do not appear to be excreted in the urine and therefore urine assays can be used to identify false-positive serum results. Serial dilutions may also be performed to assess for interference. To avoid false positives, manufacturers have incorporated animal serum and nonspecific animal antibodies into all their test ingredients. The excess of nonspecific antibodies saturates heterophilic antibodies in human serum and usually eliminates their interference with the assay (Johnson et al., 2000). Additionally, serum samples can be sent to outside laboratories with different assay systems to validate results. In our patient's case, the patient continued to have normal menstrual cycles and was using two forms of contraception with her husband who had history of vasectomy. The work up, including pelvic ultrasound and CT scans, was negative for pregnancy and trophoblastic disease. The testing for heterophilic hCG antibodies was also negative. The patient additionally had a positive urine pregnancy test inconsistent with phantom hCG. It was therefore believed that the patient's β-hCG production was due to the patient's tumor, consistent with a paraneoplastic syndrome.
Indian Official Languages Dictionary is significantly better than Google translation offers multiple meanings, alternate words list of phantom phantom phrases with similar meanings in Tamil தமிழ், Tamil தமிழ் dictionary Tamil தமிழ் phantom translation phantom meaning phantom definition phantom antonym phantom synonym Tamil language reference work for finding synonyms, antonyms of phantom.
This page is an online lexical resource, contains a list of the phantom like words in a Tamil language in the order of the alphabets, and that tells you what they mean, in the same or other languages including English. 2b1af7f3a8