Category Archives: January 2015

Endometriosis_Ashfaq

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The rare case of broad ligament endometriosis

Hassan AU,1 Khanday S,2 Zahida R,3 Ara R,4 Salem A5

1,2Department of Anatomy, Sheri Kashmir Institute of Medical Sciences College Bemina, Srinagar, Kashmir, India.3Department of Medicine, Dubai Girls endometriosis Medical College, Dubai, UAE.

4,5Department of Obstetrics and gynecology, IUST Awantipora, Srinagar, Kashmir, India.

ABSTRACT
Endometriosis is a relatively common condition. However, endometriosis at atypical sites is rare. We present a rare case of endometrium present in the broad ligament of uterus.
KEY WORDS
Broad ligament, Endometriosis, Mesosalpinx, Ovary,Mesometrium, Mesoovarium

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SCC Cervix_Diwan A

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Cutaneous metastases after radical chemoradiotherapy in carcinoma cervix: an unusual manifestation
Diwan AK,1 Subeera Khan S,2 Mahobia VK1
Assistant Professor,1,3 Resident2

1-3Department of Radiation Therapy & Oncology, Government Medical College & Hospital, Nagpur, Maharashtra, India.

ABSTRACT
Cervical cancer is one of the most common malignancy affecting women in India, however cutaneous metastasis arising from cervical cancer is particularly rare. Skin metastases are unusual even in the terminal stages of the disease with incidence ranging from 0.1% to 4.4%.Mostly they occur as a sign of recurrent disease and are associated with poor prognosis. We report a case of carcinoma of the uterine cervix with cytology proven unusual extensive metastasis to the vulva, anterior abdominal wall and thigh developing within one month of external beam radiation therapy. Cutaneous metastasis usually presents in the form of nodule, plaque and inflammatory telangiectasia. However in our case presenting symptom was an ulcer which spread to completely destroy the vulva. Adenocarcinomas of the cervix have a higher propensity for cutaneous metastasis. Skin metastases from cervical carcinoma occur predominantly in cases of tumor recurrences, with metastases developing up to 10 years after initial diagnosis. No effective treatment has been identified till date. Palliation is the aim using chemotherapy, radiation and surgery alone or in combination.
KEY WORDS
Carcinoma cervix, cutaneous metastasis radical chemoradiotherapy.

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Renal SCC_Diwan A

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Primary squamous cell carcinoma of kidney: a rare case report

Diwan AK,1 Santosh KR2

Assistant Professor,1 Junior resident2

1-2Department of Radiation Therapy & Oncology, Government Medical College & Hospital, Nagpur, Maharashtra, India.  

ABSTRACT
Neoplasms of the kidney are most commonly adenocarcinomas. Carcinomas of the renal pelvis and ureter are rare, accounting for only 4% of all urothelial cancers. Squamous cell carcinoma of renal pelvis and ureter are very rare and account for 6-15% of all renal tumours of which transitional carcinomas constitute the majority followed by adenocarcinoma and squamous cell carcinoma. Renal squamous cell carcinoma (RSCC) is a rare malignancy of the upper urinary tract characteristically presenting with advanced stage, the reported incidence being 1.4% of all renal malignancies. Very few cases have been reported in literature. Most patients have a history of chronic urolithiasis, renal infection or abuse of analgesics. This tumor is aggressive in nature and usually has a poor prognosis. We report two cases of renal squamous cell carcinoma one with characteristic history of chronic pyelonephritis and one without characteristic etiologic factors. These cases have been reported due to their extreme rarity and also highlight the silent presentation of these tumors and the need to keep it as a differential diagnosis while evaluating cases of nephrolithiasis and chronic inflammations.
KEY WORDS
Chronic pyelonephritis, renal pelvis, squamous cell carcinoma.

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PELOD Scoring_Ambey

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Modified PELOD Scoring System: A Feasible Tool in Pediatric Intensive Care Units

Ajay Gaur,1 Ravi Ambey,2 Anoop Sharma3

Associate Professor,1 Assistant Professor,2 Resident3

1-3Department of Pediatrics, G.R. Medical College, Gwalior, MP, India.

ABSTRACT
BackgroundPediatric logistic organ dysfunction (PELOD) score,which can predict mortality or multiple organ dysfunction syndrome (MODS) outcomes, has been validated for children. It is cumbersome to measure respiratory dysfunction variables included in original PELOD scoring, in ventilator and blood gas analysis limited setups, so all three variables included under respiratory dysfunction (i.e.PaO2/FiO2 ratio, PaCo2 and mechanical ventilation) in original PELOD score were replaced by three new variables (i.e. Respiratory rate, Chest retractions and Spo2). The present study aims to modify the PELOD score and make it more clinical and feasible to adopt in resource limited setups rather being dependent on sophisticated facilities.AimsEvaluation of modified PELOD scoring system to determine the prognosis of patients in Pediatric Intensive Care Units.

Method

The modified PELOD scoring system consists of physical and laboratory variables representing six organ systems namely neurological, cardiovascular, renal, respiratory, hematological and hepatic system. The score was calculated for the subjects during first 24 hours of admission in PICU. Patients were then followed until they were discharged from PICU or deceased .In each organ system, the highest score in any variable accounted was taken as the score for that organ system. The sum total of the 6 scores for each organ system gives modified PELOD score (range 0-71) which was used for looking at the association between modified PELOD score and mortality.

Results

The risk of mortality varies directly with the modified PELOD score of the patients. In those patients whose modified PELOD score was <10, mortality was 10.4%, whereas in patients whose modified PELOD score was >10, mortality increased significantly to 46.4% (χ2 = 12.000, P < 0.001).The mean (SD) modified PELOD score was considerably higher in those who died as compared to those who survived (16.25 (8.63) vs 7.68 (5.55); p<0.001).

Conclusion

The modified PELOD score can be used as a reliable prognostic predictor of mortality among PICU patients.

KEY WORDS
Modified PELOD Score, Prognosis, PICU.

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chloramphenicol_Khyati Jain

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Study on Chloramphenicol resistance pattern in Central India, Indore

Jain K,1 Tripathi S2

Assistant Professor,1 Professor2

1Department of Microbiology,Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India

2Department of Pharmacology, Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India

ABSTRACT
BackgroundChloramphenicol (CK) is drug of choice in many life threatening and serious bacterial infections. Due to development of resistance and toxicity associated with this drug, it is not in common use now days. This study was done to find out prevalence of CK resistance pattern.Material Methods100 consecutive pus samples from surgical site infections from various specialties of index medical college hospital and research center were studied in microbiology department during period of 1year. Results

Gram positive as well as Gram negative organisms had shown sensitivity to Chloramphenicol. Also organisms were resistant to commonly used higher antibiotics.

Conclusion

CK can be used for common serious IPD patients not having contraindication to this drug. Study also reinforces proper and rational use of antibiotics.

KEY WORDS
Chloramphenicol, drug resistance, gram positive and gram negative organism.

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Menstrual morbodities_Salve

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 A Study of Demographic Profile and Menstrual Morbidities amongst Adolescent Female Patients visiting a Tertiary Care CENTER

Bandkhadke G,1 Salvi P,2 Bhalerao A,3 Bhosale R,4 Chandanwale A5

Post Graduate Student,1 Assistant Professor,2 Associate Professor,3 Professor & Head,4 Dean5

1-5Department of Obstetrics and Gynaecology, B J Government Medical College, Pune, India.

ABSTRACT
Aim1) To study the demographic profile, prevalence and type of menstrual morbidities amongst 13-19 year adolescent females attending gynaecology OPD at a tertiary care government general hospital in an urban area. 2) To study the awareness on physical changes & menstruation in adolescent girls in urban area. 3) To assess their knowledge on contraceptive methods.4) To study hygiene practices followed during menstruation. 5) To Treat the patients and suggest suitable recommendations based on study findings, for the future. Background

The Latin word ‘Adolescere’ means to grow to maturity. One fifth of the world population is between 10-19 yrs old and 85% of them live in developing countries. There are very few studies on prevalence and pattern of gynaecological health morbidities amongst late adolescent female patients.

Material Methods

It is a Prospective Observational Clinical Study in a Tertiary care Centre and Teaching Institute in Urban India. Variables observed were socio-demography, menstrual morbidities and knowledge about contraception, in study patients. Chi square test of significance was applied where relevent.

Results

Out of 120, maximum patients were unmarried from low socioeconomic, large (more than 4) family. The literacy rate was 70%. Out of 120 patients, maximum (34%) attained menarche at 12 years, 62% had regular cycles and most of them used homemade cloth for hygiene during menses. The commonest menstrual morbidity was dysmenorrhoea (73%). The commonest premenstrual symptom was pain in abdomen. Thirty four percent patients had moderate to severe anaemia. Forty percent girls had some knowledge about contraception and most of them acquired it from Television. The most known method of contraception was OC pills and all patients with the knowledge felt it is available at all hospitals and chemists.

Conclusion

Adolescent Reproductive and Sexual Health(ARSH) OPD services are needed at all women care centres as these group of patients need special attention for their complaints and focused care and counseling of these young patients would be a great investment for future health of them & their families and the society & nation as a large.

KEY WORDS
Adolescent, Demographic, Morbidities, Menstruation, Contraception.

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Color Dopller_Pasupuleti

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Color Doppler evaluation of carotid vessels in patients with stroke

Pasupuleti BR,1 Narra RK,2 Kamraju SK,3 Jukuri NR,4 Sushmitha5

Professor,1,3 Associate Professor,2 Assistant Professor,4 Senior Resident5

1-5Department of Radiodiagnosis, Katuri Medical College Guntur, Andhra Pradesh, India

ABSTRACT
AimTo analyze the structure of carotid plaque morphology and quantify the percentage of carotid cerebrovascular disease is an important formidable health problem globally. The stroke syndrome consists of the rapid development of a focal neurological deficit that is usually localized to an area of the brain stenosis using high resolution color Doppler ultrasound machine in stroke patients. Background: Stroke or supplied by a specific artery.Materials and Methods

This study was carried out on all clinically suspected cerebrovascular insufficiency cases referred for color Doppler of carotid arteries to the Radiology Department of Katuri Medical College and Hospital, Guntur from 2011 to 2013. Various Doppler parameters such as characteristics of plaque, degree of stenosis, peak systolic velocity ratio, end diastolic velocity (EDV) of internal carotid artery, EDV ratios were studied.

Results

Totally 90 cases of cerebrovascular accident studied, 58 (64%) were males and 32 (36%) were females. The majority of male patients belonged to age group of 51-60 years (37.8%) and females 61-70 years (37.5%). The risk factors included hypertension, smoking, diabetes mellitus, and ischemic heart disease. The patient’s clinical symptoms included hemiparesis, hemiplegia, transient ischemic attack and altered sensorium.

Conclusion

Color Doppler of carotid artery plays an important role in the identification of plaques and quantification of degree of stenosis and identification of “at risk” patients who may develop further stroke.

KEY WORDS
Color Doppler, carotid vessels, common carotid artery, end diastolic velocity, internal carotid artery, peak systolic velocity, plaque, stroke.

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Acute Post Strepto GN_Narang

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Acute Post Streptococcal Glomerulonephritis

Narang S

Professor

Department of Pathology, Index Medical College Hospital and Research Center, Indore, MP, India.

MEDICAL POEM
-Follows streptococci after one to two weeksPatients between six to sixteen it seeks.-Beta heamolytic streptococci, culprits mainInto glomeruli, a hold they gain.-Antibodies like ASO, AHase, Askase abound

Elevated titres are invariably found.

-Enlarged are kidneys in a symmetrical manner

Heamorrhages cortical, give it a flea bitter “banner”.

-Enlarged and hypercellular glomeruli are present

Proliferative and exudative activity they represent.

-“Humps” are deposits election dense

Seen on epithelial side of the fence.

-With Immunofluorescence, study them you do

Composed they are of IgG and C3 too.

KEY WORDS
Acute Post Streptococcal Glomerulonephritis

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Calcinosis_Rakesh Jain

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Calcinosis Cutis

Jain R,1 Jain P2

Senior Resident1, Lecturer

1Department of Cardiology, Government Medical College, Calicut, Kerala, India.

2Department of Pediatrics, Government Medical College, Calicut, Kerala, India.

ABSTRACT
Calcinosis cutis may a manifestation of different underlying pathophysiology. Therefore, after clinical diagnosis of calcinosis cutis, a laboratory workup to rule out abnormalities of calcium and phosphorus metabolism, malignant processes, collagen vascular diseases, renal insufficiency, excessive milk ingestion, vitamin D poisoning must be carried out to detect the underlying cause of the disease.
KEY WORDS
Calcinosis cutis, Dystrophic calcification, Tumoral calcinosis.

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Giant Lipoma_Gaur Rajesh

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Giant Lipoma In Front Of Neck Presenting As Thyroid Neoplasm – A Rare Case 

Gaur R,1 Sharma RL,2 Rai S,3 Jain D4

Professor & Head,1 Associate Professor,2 Demonstrator,3 Resident4

1-4Department of Pathology, G R Medical College, Gwalior, Madhya Pradesh, India.

ABSTRACT
Lipoma is the most common benign soft tissue mesenchymal tumor of adipose tissue. Their occurance in head and neck is relatively rare and is most frequently located in posterior subcutaneous neck region. In this article we report the giant mass in front of neck in 65 year old woman measuring 32cm x 30cm which was increasing slowly since 18 years causing pressure symptoms like dysphagia, dyspnea. It was clinically diagnosed as thyroid neoplasm and confirmed by histopathological examination.
KEY WORDS
Giant lipoma, Head and neck,  Lesions in neck,  Lipoma.

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