An observational study to find out changes in arterial oxygen tension during fiberoptic bronchoscopy

Background:Arterialhypoxaemiaisthecommonestcomplication,sincerespiratory depressantdrugsareusedforpremedication,andtheairwayisalsopartially occludedbythebronchoscope.Thestudyisthereforedesignedtofindoutthechangesinarterialoxygen tensionduring (FOB)alongwitheffectoncentral hemodynamics, pre andpost procedure ECGand PFT.Objectives were tofind out thechanges in arterial oxygentension during FOB, to study the effects of FOBon central hemodynamics, electrocardiographicallyand pulmonaryfunction tests.Methods:One hundred patients aged above 20 years undergoing FOB were evaluated for the arterial oxygen tension and cardiac rhythm changes at KNCH, Jodhpur during 12 months study period from 2019 to 2020.Results:All patients developed a fall in PaO2following FOB but hypoxaemia was noted only in 18 cases. Bronchial washing, punch biopsy and brush biopsy did contribute to hypoxaemia significantly. There was a uniform rise in heart rate in all the patients after FOB which was statistically significant. There was slight sinus tachycardia inmostofthecases although ECG indicated no major arrhythmias.ThepulmonaryfunctionswhichincludechangeinVC,FVC, FEV1andPEFR after FOB, on statisticallycomparisonnostatistical difference could be observed. Therewasnosignificantchangein PaCO2level and pH level.MeanofSBP andmeanofDBPwasstatistically significant.Conclusions:All patients showed a decline in arterial PaO2after FOB which was highly significant. There was slight sinus tachycardia in most of cases. FOB itself does not endanger the patients with any significant or serious complications.

Synovial cell sarcoma of the pleura: an uncommon cause of a haemorrhagic pleural effusion

Soft tissue tumors account for a small percentage of malignancies and synovial sarcomas account for 10% of soft tissue tumors in our body, among them are the synovial sarcomas (SS).These arise from various sites and are of mesenchymal origin, Primary pleural synovial sarcomas are very rare tumours and account for not more than 0.5% of lung malignancies, they are being diagnosed mainly by the immunohistochemistry and classical cytogentic translocation t(x;18). This tumor has no sex preference and is commonly seen in the age group of 30-45.Our case is of a elderly male with massive pleural effusion who was diagnosed as having biphasic variant of synovial sarcoma of pleura by the help of immunohistochemistry. Treatment is mainly surgical resection and chemotherapy with ifosfamide/ adriamycin or radiotherapy. It must be considered as differential for biopsy proven malignant mesothelioma and hence immunohistochemistry should be must for all biopsy proven mesotheliomas.

Comparative Study of Methanolic Extract of Banana, Ranitidine and Omeprazole on Total Acid Secretion and Gastric Ulcer Healing Effect in Albino Rats

Introduction: The commonest day to day ailment of humanbeings is the gastrointestinal diseases. Apart from traditionaluses, there are several reports on important pharmacologicalactions of musa sapientum. Study aimed to compare acidsecretion and ulcer healing effect of methanolic extract ofbanana, ranitidine, and omeprazole.Material and methods: The present study was carried out on30 albino rats for a period of 7 days. The animals were dividedrandomly into 5 groups of 6 animals each. Group I or controlgroup received 3% gum acacia suspension orally for 7 days.Group II, III, IV and V received 100mg/kg of aspirin orally asa single dose the 7th day. Group III was pretreated with 100mg/kg of MSE orally for 7 days. Group IV was pretreated with 20mg/kg omeprazole and Group V was pretreated with 150mg/kg of ranitidine orally for 7 days. After the administration ofthe drugs on the 7th Day, the albino rats were fasted for 24 hrsand then sacrificed after 4 hrs of pyloric ligation.Results: In the control group (n=6) the values of ulcer index(µmol tyrosin/ml), free acidity (mEq/l), total acidity (mEq/l),and volume of gastric juice (ml/4 hrs) were 0.22±0.01,53.25±2.59, 72.24±4.19 and 5.1±0.32 respectively. Whencompared to aspirin treated group, the MSE pretreated group(100 mg/kg) single dose orally on 7th day showed significantreduction (p<0.01, n=6) of ulcer index, free and total acidity(mEq/l), and volume of gastric juice (ml/4 hrs), whosevalues were 5.3±0.46, 71.31±4.15, 72.24±4.19 and 65.4±2.9respectively.Conclusion: The present study suggests that themethanolic extract of musa sapientum possesses significantulceroprotective effect, which is comparable to omeprazoleand ranitidine, except for gastric juice, where the effect ofomeprazole was more. The observations of the present studyputs forward omeprazole as a promising ulceroprotectiveagent, but further studies with more refined extracts andtechniques on animal and human subjects are requiredto establish the true potential in terms of therapeutic andeconomic viability of this herbal plant.

Correlation of H. pylori density with grading of chronic gastritis.

Histopathological study of endoscopic gastric mucosa obtained from 251 patients with acid peptic diseases were studied in relation to the degrees of inflammation and the degree of H. Pylori density. Haematoxylin-Eosin and modified Giemsa stains were used. Gastritis grading was done according to Warren and Marshall with slight modification and H. Pylori grading according to our criteria. In this study no definite relationship could be observed between histological grading of chronic gastritis with that of H. Pylori density.

Malignant retrorectal teratoma presenting as an infected perianal sinus.

Retrorectal teratomas are rare tumours arising in the presacral space. We report a case of malignant retrorectal teratoma which presented as an infected perianal sinus. The patient was treated with abdominoperineal resection.