Tubular enteric duplication presenting as jejuno-colic fistula in a 38 years old adult

Colo-enteric fistula is a rare entity, malignancy being the commonest cause. Both adenocarcinoma and rarely lymphoma have been known to cause it. Benign jejuno-colic fistulas are mostly secondary to tuberculosis or inflammatory bowel disease. Here we present a case of a young adult male, who presented with altered bowel habits. Colonoscopy and oesophago-gastro-duodenoscopy (OGD) revealed a fistulous tract between the proximal jejunum to the splenic flexure of colon. Surgery revealed a small fistulous connection between the above-mentioned parts of the bowel about 1cm long. Histopathology demonstrated it to have all the layers of the intestinal anatomy, hence indicating a possibility of congenital aetiology, probably enteric duplication of communicating tubular variety.

Primary hydatid cyst of the mesentery presenting as a small bowel volvulus

Hydatid disease mostly caused by Echinococcus granulosus (dog tape worm) is a common parasitic disease in pastoral areas. It produces cysts in the human body. Human is an accidental intermediate host. Most common sites are liver and lungs. Intraperitoneal hydatid cyst occurs sometimes and it is usually secondary to rupture of primary hepatic hydatid cyst. Primary intraperitoneal hydatid cyst is rare (2%). Primary hydatid cyst in mesentery is very rare. Small bowel volvulus is rare but documented complication of tumours of the mesentery, including cysts. In this article, the authors present a case of primary mesenteric hydatid cyst with acute intestinal obstruction secondary to volvulus.

Fluid Structure Interaction of Renal Arteries of Abdominal Aorta Subjected to Single and Double Stenosed Complication

@#Introduction: In this study, Renal artery (RA) stenosis of Single Stenosed (SS) and Double Stenosed (DS) with the condition of Normal Blood Pressure (NBP) and High Blood Pressure (HBP) were investigated using the aid of Fluid Structure Interaction (FSI) approach. Methods: Numerical analysis of 3D model patient’s specific abdominal aorta with RA stenosis was conducted using FSI solver in software ANSYS 18. Results: The results of velocity profile, pressure drop, time average wall shear stress (TAWSS), Oscillatory shear index (OSI) and total deformation of SS and DS with the condition of NBP and HBP were compared in terms of blood flow and structural wall tissue behaviour. The results concluded SS-NBP produced the highest value of velocity profile, TAWSS and OSI parameter compared to the others. Meanwhile, SS-HBP indicates the highest value pressure drop. On the other hand, SS-HBP and DS-HBP have a higher distribution of deformation contour and also maximum VMS compared to SS-NBP and DS-HBP. Conclusion: With the aid of FSI approach, this studied has proven that the existence of SS at RA location has a higher impact on the velocity magnitude, higher pressure drop, higher TAWSS and OSI value compared to the DS case. This is due to a high concentration of pressure acting at the narrow blood vessel of SS compared to DS cases which most of the blood flow will pass to the lower part of abdominal aorta.

Paget's disease from Western India.

AIM AND OBJECTIVE: To prospectively study prevalence of Paget's disease from Western India. METHODS AND MATERIALS: Seventeen consecutive cases from Western India from 1998 to 2005 are analysed for the clinical, biochemical, skeletal profile. Seventeen cases (15 males & 2 females) with mean age of 62 were diagnosed RESULTS: The Western Indian cohort of Paget's disease has male preponderance with a mean age of 62 years at onset. Its clinical features are pain, fracture and typical skeletal involvement. It is a non-familial, polyostotic disease with pelvis, skull, spine and femur being the commonly affected bone sites. Elevated alkaline phosphatase is typical which responds well to bisphosphonate therapy in 6 months. Most cases do well with low dose alendronate (10-20mg/day). CONCLUSIONS: Paget's disease in western India is rare with classical clinical, radiological and biochemical features and responds well to low dose alendronate therapy. In eight years, seventeen cases of Paget's disease were seen from Western India indicating though still rare is present in this population of Western India.

Efficacy of antioxidants as an adjunct to photochemotherapy in vitiligo: a case study of 30 patients.

Low levels of antioxidant enzymes (catalase) have been demonstrated in the epidermis of vitiligo patients. Clinical trials with antioxidants as an adjunct to UVB phototherapy have shown encouraging results. The aim of this study was to determine the efficacy of oral antioxidants as an adjunct to photochemotherapy. Thirty patients of stable vitiligo, not on any treatment fort month were included in the study. Fifteen patients were treated with photochemotherapy alone and another 15 were treated with photochemotherapy and oral antiodixants (1 capsule od). Two index lesions were assessed in each patient, prior to treatment, 1 month and 3 months after treatment. Average area was calculated by Computer Aided Design. Patients were monitored for side effects to photochemotherapy and antioxidants. Percentage decrease in the area of index lesions was calculated after 3 months. No statistically significant difference was noted between the two regimes. No side effects specific to antioxidant therapy were observed. Antioxidants as an adjunct to photochemotherapy offer no distinct advantage and antioxidant therapy is free of adverse effects.

Dermabrasion and cryotherapy in the treatment of verrucous nevus- a case report

Verrucous nevus is a difficult condition to treat. Treatment with dermabrasion or cryotherapy is usually associated with recurrences. In this article a case of verrucous nevus successfully treated with dermabrasion and liquid nitrogen cryotherapy is being reported

Acquired haemoglobin H disease in a case of myelodysplastic syndrome.

A case of acquired haemoglobin H (HbH) disease with underlying myelodysplastic syndrome in the form of acquired idiopathic sideroblastic anaemia is reported. Family studies and subsequent drop in HbH percentage strongly supported the acquired nature of the defect.