Uncommon presentation of common disease.

Tuberculosis is a chronic, granulomatous disease. Primary lesion usually occurs in the lung. Extra pulmonary infection commonly involves head, neck and abdomen. In the absence of typical features of tuberculosis, tuberculous cellulitis mimicking oral infection may pose a challenge for diagnosis. In an attempt to highlight an uncommon presentation, we document a case of extra pulmonary tuberculosis in the parotid gland (tuberculous parotitis), without evidence of pulmonary tuberculosis and HIV. A 30 year old female from low socio-economic status reported with pain in front of the left ear and difficulty in opening her mouth. Swelling was present on left side of the face without evidence of intraoral focus of infection. She was diagnosed to be having tuberculosis of parotid gland after fine needle aspiration cytology (FNAC), Ultrasonography (USG) and histopathological examination and was treated medically and surgically.

An echocardiographic study of net atrioventricular compliance in juvenile and adult mitral stenosis.

BACKGROUND: Left atrial compliance is an important determinant of symptoms in mitral stenosis. About one-third of patients with mitral stenosis have reduced left ventricular compliance. We measured the net atrioventricular compliance in rheumatic mitral stenosis patients noninvasively and analyzed if there were any clinical, electrocardiographic, roentgenographic or echocardiographic correlates of net atrioventricular compliance. METHODS AND RESULTS: Seventy-six patients with mitral stenosis were analyzed and as many normal subjects were taken as control group. Patients were divided into two groups--those 20 years and below were grouped as juvenile mitral stenosis and those above 20 years as adult mitral stenosis patients. The net atrioventricular compliance in patients with mitral stenosis was significantly impaired compared to normal population. Mean compliance in juvenile group was 4.66+/-2.18 ml/mmHg (range 2.17-9.6) and in adult group it was 4.79+/-1.99 ml/mmHg (range 2.04-8.9) (p = ns). There was no difference in net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. Mitral valve area showed an independent positive correlation with net atrioventricular compliance. CONCLUSIONS: The net atrioventricular compliance was significantly reduced in patients with rheumatic mitral stenosis; however, there was essentially no difference in the net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. The net atrioventricular compliance may not be responsible for the more severe symptoms observed in juvenile mitral stenosis.