ABSTRACT
Background: The incidence of acute abdomen during pregnancy is approximately 1 in 500 pregnancies. The incidence of symptomatic gallstone disease in pregnancy is reported in approximately 0.2-0.5 per 1,000 pregnancies. Symptoms are similar to those in the nonpregnant state. A delay in diagnosis may increase the risk of perforation. Treatment in most cases is conservative. However, recent trends, newer instrumentation and skilled personnel encourage arranging laparoscopic cholecystectomy at the time of diagnosis.Methods: This study was a retrospective study, included 117 pregnant patients with acute gallstone disease, who were treated and followed-up at Government Medical College, Srinagar, Department of General Surgery and Department of Gynae And Obstetrics, between January 2015 and April 2017.Results: The mean age of patients in our study was 28.6 years. Majority of patients 56 (47.86%) were in is trimester of pregnancy. Parity of the patients varied from 1 to 6, with a mean parity of 2.67. The presentation of majority of patients was colicky pain right upper abdomen,108 (92.30%). All patients had gallstones on USG scan.101(86.32%) patients had acute cholecystitis, while 8 (6.83%) patients had predominant features of acute pancreatitis,8(6.83%) patients had accompanying choledocholithiasis The average wall thickness of gallbladder in our patients was 4.62 mm. Majority 106 (90.59%) patients were managed conservatively. 8 (6.83%) patients underwent cholecystectomy in same admission, after failure of conservative management, 7 patients underwent laparoscopic cholecystectomy and one underwent open cholecystectomy. 3 patients (2.56%), who had features of cholangitis were managed by ERCP. The average length of hospital stay in our patient group was 8.61 days. There was one maternal death reported in our study, there were a total of 8 (6.83%) preterm deliveries.Conclusions: Symptomatic gallstone disease in pregnancy is a common surgical problem. Diagnosis during pregnancy can be difficult, majority of cases can be managed conservatively, intervention whenever indicated must be undertaken.
ABSTRACT
Introduction: Localized scleroderma is a rare disorderwith not well recognized aetiology. Though consideredto be a benign disorder it may result in a severe cosmeticdisfigurement or even functional disability. There is no proveneffective therapy for localized scleroderma so far makingmanagement of such cases challenging. Lack of evidencebased treatment and standardization of evaluation methodsmay be reason for it. The Study was conducted to evaluatethe role of corticosteroid and methotrexate therapy in ourpopulation with severe localized scleroderma (morphoea).Material and Methods: All patients attending with OPD inDepartment of Dermatology SKIMS-MCH from Jan, 2014,to Jan, 2019, with clinical features suggestive of active,moderate to severe morphoea were enrolled in the study. Adetailed clinical history was followed by a thorough clinicalexamination and calculation of LoSSI score. Patients werestarted on i/v methyl-prednisolone 30mg/kg monthly pulsesas 3 consecutive doses for 3 months (maximum 1gm) andintramuscular MTX at 0.2 to 0.4 mg/kg/week (maximum 25mg/week) for 12 months.Results: A total of 21 patients were included in the study.Male: Female ratio was 1:3.2. Mean age was 21.19years.Linear morphoea was most common type (13 cases) followedby plaque morphoea (6 cases). There was a significantdecrease in mean LoSSI score (from 15.19 to 6.62) at 4months after completion of steroid methotrexate phase (valueof t is -8.621425, value of p is < .00001). Mean LoSSI scoreafter completion of 12 months of treatment was 0.94 (valueof t is -9.644953, value of p is < .00001). The treatment waswell tolerated.Conclusion: The study suggests that systemic corticosteroidsand methotrexate in combination is effective and well toleratedtreatment for both adults and children with localized moderateto severe scleroderma.
ABSTRACT
Ellis-van Creveld (EVC) syndrome is a rare autosomal recessive congenital disorder characterized by chondrodysplasia and polydactyly, ectodermal dysplasia and congenital defects of the heart. We present here a case of a 16-year-old short-limbed dwarf with skeletal deformities and bilateral postaxial polydactyly, dysplastic nails and teeth, also having left-sided facial hemiatrophy. The diagnosis of EVC syndrome was made on the basis of clinical and radiological features. To the best of our knowledge, this is the first report of EVC syndrome with facial hemiatrophy in the medical literature from India.
ABSTRACT
BACKGROUND: Alopecia areata (AA) is a recurrent, nonscarring type of hair loss considered to be an autoimmune process. Though its etiopathology is not fully understood, there are claims that imbalance of trace elements may trigger the onset of AA. AIM: The aim of the present study was to assess the levels of zinc, copper, and magnesium in the serum of AA patients. METHODS: Fifty AA patients (34 men and 16 women), and fifty age and sex matched healthy control subjects were studied. Samples were analyzed using atomic absorption spectrometric methods. RESULTS: Serum zinc levels were significantly decreased (P < 0.05) in AA patients whose disease was extensive, prolonged, and resistant to treatment, whereas serum copper and magnesium levels showed insignificant rise compared to controls. CONCLUSION: We conclude that copper and magnesium levels are not altered in AA, but the decreased zinc levels found in our study may merit further investigation of the relationship.