Figure 1: pre-operative imaging

Figure 2: surgery and post-operative imaging

Subluxation of eyes in a child with Crouzon Syndrome.

3-year-old boy, diagnosed case of Crouzon syndrome, presented with sudden protrusion of both eyes out of the orbit during a bout of cough . On examination, vitals were stable. Bilateral subluxated eyes were seen, with normal cornea and anterior chamber. Pupils were bilaterally equal and reacting. Eye ball movements were absent with normal intra-ocular pressure; fundus was normal. Anterior narrowing of the head was present with a normal head circumference. Examination of limbs as well as systemic examination was within normal limits. Eyes were repositioned and emergency lateral tarsorrhaphy was done, following which the child had normal vision with no residual damage. After a month, he underwent surgical correction of craniosynostosis and orbital reconstruction, and there has been no recurrence of subluxation of eyes thereafter.

While subluxation of globe is rare in children, Crouzon syndrome is known to be a predisposing factor. Timely repositioning usually results in a good outcome.

Macroglossia = BIG-ASS TONGUE

Surgical correction

it needed reconstructive surgery using a donor Achilles.

Figure 1: (A) A swelling of 20×15 cm is present over the left upper arm with venous engorgement and a scab mimicking the nipple-areola complex over the swelling. (B) The skin underlying the swelling was within the normal limits, and the axilla was also within normal limits.

Figure 2: (A) An X-ray of the local region, posteroanterior view, showing normal soft tissue and bones. (B) There are no microcalcifications over the swelling.

Figure 3: (A) An intraoperative picture showing the surgical excision of the swelling being done and hemostasis being achieved. (B) An intraoperative picture showing the swelling excised as a whole. (C) An intraoperative picture showing the wound being sutured using nylon 2-0 sutures.

Figure 4: A cut and resected specimen measuring 22×14 cm from the left upper arm following the procedure: (A) horizontal alignment of the resected specimen and (B) vertical alignment of the resected specimen.

I broke my leg in three places, had a grade three open fracture of the tibia and fibula, broke my foot in two places one being the heel bone I can't remember the other bone in the foot

I don't speak this language, but it was still a cool vid

Michael Meloy was an Irish man who immigrated to New York just before the Great Depression it was know that he had a sever drinking problem and a group of men called “the murder trust” put multiple life insurance contracts on Michael as a way to make ends meet. However they underestimated the durability of an Irish man's liver the seeming leading member of the murder trust a man called Antony Marino who was the owner of a speak easy (illegal bar during prohibition) pictured here

The initial plan was to simply drink Meloy to death as he was an alcoholic in New York during the prohibition it would be seen similarly to how a death by heroin overdose is now. However night after night Meloy would simply pass out in his chair be carried to a back room in the hopes he'd had enough to do him in however night after night Meloy would get back up and order another round.

The next plan the group came up with was wood alcohol aka methol alcohol which is alcohol distilled from wood it has very similar effects and damage as anti freeze or mentholated spirits however the group would serve Meloy a tray of shots of normal whisky or whatever other spirit they had to hand first to try and keep him from finding out but mixing wood alcohol with normal alcohol simply nullifies the effect of wood alcohol on humans.

Enough of the boring shit let's get a little weird with it

The groups next plan came from a strange place a memeber of the Murder trust was formerly a funeral director and he had had to bury a man who had died from from a lethal combination of alcohol and a large amount of raw oysters.

So the groups plan was to pickle a large plate worth of raw oysters in wood alcohol to serve to Michael when he came back to the bar however.

Michael happily gulped down every last oyster and politely asked Marino for seconds.

Marino fucking raging at this point that Michael refused to die just started raiding the cupboards for anything toxic to mix into his food

By this point meloys main diet consisted of extremely large amounts of alcohol and sandwiches filled with extra ingredients including but not limited too

Horse liniments

Carpet tacks

crushed glass from damaged drinking glasses

And fucking rat poison

However again Michael had no issues wolfing it down and he even joked with Marino that instead of owning a speak easy Marino should open a restaurant instead.

By this point the murder trust was absolutely done with Maloy surviving and decided instead they should try to speed it up however they couldn't risk just murdering him out right as that would lower the payout.

On a snowy night half a month into meloys poison binge he passed out in his chair and instead of bringing Meloy to the rest room they took him by taxi to a local park before dumping him in the snow and ripping his clothes in the hopes he'd die of hypothermia. the group couldn't stick around as they didn't want to be connected with the death. But Meloy wasn't dead AGAIN. he was actually found by a pair of police officers who took him to a local homeless charity who took him in fed him re clothed him and told him to try be careful where he passed out. Before he made his way back to Marianos speak easy for another few rounds.

They then tried to have him murdered with a car they approached several hitmen gangsters and cabby's before finding there man and making there plans this time Meloy was struck and run over by the car 3 times the group were going to try and confirm his death but got spooked when some passers by started coming a bit too close and fled.

However after 3 weeks the group could find absolutely no trace of Meloy they checked morgues police stations and obituaries but couldn't find a trace of him.

the group began to worry that Meloy was simply buried as a jon doe and it had all been a waste. That was until the door Swang open and Meloy walked in cheerfully apologising for taking so long to come back around and explaining he was in hospital for only 3 weeks after being ran over 3 fucking times all that happened was a concussion a fractured skull and a broken shoulder.

The murder trust were at there wits end at this point and decided they were going to take matters into there own hands that night when Meloy passed out he was taken to the back room and had a gas outlet tube placed down his throat killing him with a large dose of carbon monoxide .

the photo at the top of the post is the only real photo we have of michael meloy This photo was taken in a police morgue after his body was exhumed for the investigation of the murder trust. Resulting in all but one being executed by electric chair. But mister Meloy was only a homeless man he was layed to rest in a unmarked grave in Fern cliff cemetery and mausoleum .

Image 1: A) Placement of underlay mesh (star marks intercostal hernia defect, arrow points cranial)

Image 2: B) closure of intercostal hernia with Tiger Tape (arrow points cranial)

Image 3: A) Intrathoracic image of underlay mesh (star marks mesh, circle marks diaphragm)

Image 4: B) overlay mesh (arrow points cranial)

A 28-year-old woman presented to the emergency department with a 5-day history of worsening redness, irritation, and discharge in the right eye. Examination of the eye showed periocular swelling, conjunctival injection, and chemosis as well as purulent discharge. She received topical moxifloxacin, dexamethasone, and ganciclovir and intravenous ceftriaxone, metronidazole, and acyclovir, but despite this treatment, conjunctival necrosis, marked orbital inflammation, and ophthalmoplegia developed (Panel A).

Emergency canthotomy and cantholysis were performed to decompress the orbit, and necrotic tissue was débrided (Panel B). Two weeks before the patient's symptoms had developed, her pet cat had developed lesions on the paws (Panel C) and head. Polymerase-chain-reaction (PCR) tests of scrapings from the lesions taken by a veterinarian were positive for orthopoxvirus, and a PCR test of a conjunctival swab from the patient was also positive for orthopoxvirus.

Genome sequencing confirmed a diagnosis of cowpox. The patient was treated with tecovirimat, which inhibits the orthopoxvirus VP37 envelope wrapping protein, and also received oral prednisolone, topical dexamethasone, and topical moxifloxacin. She underwent additional surgical débridement 2 months later and received a prolonged course of tecovirimat. At follow-up 6 months after presentation, visual acuity in the patient's right eye was 20/20, although she had a mild residual ptosis and some restriction of extraocular movements, mainly elevation and adduction of the right eye.